Individual
DR. JOSEPH PRUSACZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13035 OLIVE BLVD, SAINT LOUIS, MO 63141-6173
(314) 434-3114
(314) 434-3117
Mailing address
1623 TIMBERLAKE MANOR PKWY, CHESTERFIELD, MO 63017-5593
(314) 434-3114
(314) 434-3117
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
31728
MO
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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