Individual
ROBERT M PRUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 S MADISON ST, TRAVERSE CITY, MI 49684-2321
(231) 392-8400
(231) 935-7126
Mailing address
PO BOX 84868, CHICAGO, IL 60689-4868
(231) 392-8400
(231) 935-7126
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
050323
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B48923
—
MI
Enumeration date
07/21/2006
Last updated
02/17/2026
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