Individual
CHUCK G PRUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
19415 DEERFIELD AVENUE, SUITE 112, LEESBURG, VA 20176-8470
(703) 724-1195
(703) 724-4495
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0102203292
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407049265
—
VA
05
—
30016803970001
—
VA
Enumeration date
08/23/2007
Last updated
03/18/2024
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