Individual
DELICIA JANELLE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 CONCENTRIC BLVD, SAGINAW, MI 48604-9311
(989) 746-7500
Mailing address
1000 HOUGHTON AVE, SAGINAW, MI 48602
(989) 746-7500
(989) 583-6955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076054
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G310660
BCBS
MI
01
—
0997569
HEALTHPLUS
MI
01
—
1012438
MCLAREN HEALTH PLAN
—
01
—
142119
GREAT LAKES HEALTH PLAN
—
01
—
296
COMMUNITY CHOICE
MI
01
—
381908328
TRICARE
—
01
—
4686660
MOLINA HEALTH CARE
MI
05
—
4686660
—
MI
01
—
7484518
AETNA
—
01
—
P33641F
BLUE CARE NETWORK
MI
Enumeration date
10/06/2005
Last updated
09/27/2023
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