Individual
MARK CLEVELAND PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
67 CREEKSIDE PARK CT, GREENVILLE, SC 29615-4810
(864) 522-3700
(864) 522-3705
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25985
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259856
—
SC
Enumeration date
09/30/2005
Last updated
06/09/2016
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