Doctor Name: | DR. DONALD S PRUETT |
NPI Number: | 1225065485 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 27599 |
Business Practice Address: | 3009 N Ballas Rd 132a Saint Louis, MO - 631312322 |
Business Phone Number: | 3149956999 |
Business Fax Number: | 3149957064 |
Mailing Address: | Po Box 11750, SAINT LOUIS |
State: | MO |
Postal Code: | 631050550 |
Phone Number: | 3144322580 |
Fax Number: | 3144320223 |
NPI Enumeration Date: | 06/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 27599 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |