Individual
MR. MICHAEL FREDERIC PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3650 J DEWEY GRAY CIR, AUGUSTA, GA 30909-1867
(706) 863-9797
(706) 860-7686
Mailing address
3650 J DEWEY GRAY CIR, AUGUSTA, GA 30909-1867
(706) 836-9797
(706) 860-7686
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1932
GA
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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