Individual
DR. MARION EUGENE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-7967
Mailing address
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-7967
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23496
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007006261S
HUMANA
—
05
—
1649224650
—
WI
Enumeration date
05/22/2006
Last updated
03/15/2023
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