Individual
DIRK THOMAS PRUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8311 MONTGOMERY RD, CINCINNATI, OH 45236-2227
(513) 985-3700
(513) 985-3706
Mailing address
4685 FOREST AVE, STE C, CINCINNATI, OH 45212-3359
(513) 569-6117
(513) 853-4740
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
53309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589797
—
OH
Enumeration date
08/09/2005
Last updated
06/09/2017
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