Individual
DR. CHRISTOPHER S PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD, 132A, SAINT LOUIS, MO 63131-2322
(314) 995-6999
(314) 995-7064
Mailing address
PO BOX 11750, SAINT LOUIS, MO 63105-0550
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2002008093
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142452
GHP/CMR INDIV PROV#
MO
01
—
149044
BCBS PROV#
MO
01
—
1700551
UHC PROV#
MO
05
—
205865710
—
MO
01
—
43907V43709
HEALTHCARE USA PROV#
MO
01
—
462626
HEALTHLINK PROV#
MO
01
—
7737284
AETNA PROV#
MO
01
—
P00036769
RR MCR INDIV PROV#
MO
Enumeration date
06/22/2006
Last updated
08/10/2010
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