Individual
CHARLES PRUCHNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
202 10TH ST SE, CEDAR RAPIDS, IA 52403-2414
(319) 247-3899
Mailing address
202 10TH ST SE, CEDAR RAPIDS, IA 52403-2414
(319) 247-3899
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-27892
IA
207R00000X
Internal Medicine Physician
27892
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101865
—
IA
Enumeration date
06/01/2006
Last updated
05/09/2018
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