Individual
DR. STEVEN W PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1104 MARTHA BERRY BLVD NE, ROME, GA 30165-1612
(706) 291-2077
(706) 235-4177
Mailing address
1104 MARTHA BERRY BLVD NE, ROME, GA 30165-1612
(706) 291-2077
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
045319
GA
2085P0229X
Pediatric Radiology Physician
045319
GA
2085R0202X
Diagnostic Radiology Physician
Primary
045319
GA
2085U0001X
Diagnostic Ultrasound Physician
045319
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
524527
BCBS OF GEORGIA
GA
Enumeration date
09/20/2006
Last updated
09/05/2007
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