Individual
ANTHONY GENE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 BLYTHEWOOD RD, BLYTHEWOOD, SC 29016-8426
(803) 788-6360
Mailing address
121 BLYTHEWOOD RD, BLYTHEWOOD, SC 29016-8426
(803) 788-6360
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
93380
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061506129008
—
UT
Enumeration date
07/12/2005
Last updated
06/18/2025
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