Individual
BRYAN PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
48 MEDICAL PARK DR E, SUITE 355, BIRMINGHAM, AL 35235-3400
(205) 838-3036
(205) 838-5832
Mailing address
48 MEDICAL PARK DR E, SUITE 355, BIRMINGHAM, AL 35235-3400
(205) 838-3036
(205) 838-5832
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
AL21218
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000048036
—
AL
01
—
160007725
RAIL ROAD MEDICARE
AL
01
—
51018483
BLUE CROSS AND BLUE SHIEL
AL
01
—
7412000
UNITED HEALTH CARE
AL
Enumeration date
08/20/2006
Last updated
07/09/2007
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