Individual
CHARLES L PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N EWING ST, LANCASTER, OH 43130-3372
(740) 687-8000
(740) 687-8939
Mailing address
PO BOX 713464, CINCINNATI, OH 45271-0001
(740) 687-8990
(740) 687-8230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35048030
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0867807
—
OH
01
—
35048030
OHIO STATE MEDICAL LICENS
OH
Enumeration date
11/07/2005
Last updated
05/31/2011
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