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Individual

PETER B PRUETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2550 S PARKER RD, STE 206, AURORA, CO 80014-1622
(303) 306-7783
(303) 306-7753
Mailing address
2550 S PARKER RD, STE 206, AURORA, CO 80014-1622
(303) 306-7783
(303) 306-7753

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29651
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01296516
CO
01
840428757014
RMHD
01
DE82504
BCBS
Enumeration date
12/27/2005
Last updated
05/21/2008
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