Individual
DAWN MARIE PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
454 E BROAD ST STE 100, ROCHESTER, NY 14607-1724
(585) 276-7640
Mailing address
454 E BROAD ST STE 100, ROCHESTER, NY 14607-1724
(585) 276-7640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
282231
NY
207Q00000X
Family Medicine Physician
Primary
283231
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04448371
—
NY
Enumeration date
06/06/2013
Last updated
07/17/2024
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