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Individual
ALEXANDER PRUITT
Active
Individual
ALEXANDER PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
29040
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1091892
—
IA
01
—
1948
MIDLANDS CHOICE
NE
01
—
204803800
US DEPT OF LABOR
—
01
—
29770
SIOUX VALLEY HLTH PLNS
SD
01
—
36190
BLUE CROSS BLUE SHIELD
IA
05
—
7712720
—
SD
01
—
P00266324
RAILROAD MEDICARE
—
Enumeration date
08/25/2006
Last updated
07/25/2008
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