Individual
MRS. ELISABETH PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30575 WOODWARD AVE, ROYAL OAK, MI 48073-0980
(248) 663-1900
(844) 226-0093
Mailing address
26211 CENTRAL PARK BLVD STE 201, SOUTHFIELD, MI 48076-4158
(833) 667-3627
(833) 972-5509
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA059735
PA
Other
Enumeration date
05/03/2018
Last updated
04/23/2026
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