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Individual
DR. PRUDENCE C MBU
Active
Individual
DR. PRUDENCE C MBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38825
SC
207R00000X
Internal Medicine Physician
MD44169
TN
208000000X
Pediatrics Physician
MD44169
TN
Other
Enumeration date
07/13/2007
Last updated
01/09/2017
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