Individual
DANIEL B. PRUDICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-4444
(304) 927-6807
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-4444
(304) 927-6807
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14183
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072501-000
—
WV
Enumeration date
03/28/2006
Last updated
07/08/2007
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