Individual
TIMOTHY L. PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414
(612) 884-0649
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
0101040520
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007398778
—
VA
Enumeration date
03/08/2007
Last updated
07/21/2022
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