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Individual

DR. RYAN SANFORD PRUDOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1210 W UNIVERSITY AVE, GEORGETOWN, TX 78628-5333
(216) 513-2236
Mailing address
1210 W UNIVERSITY AVE, GEORGETOWN, TX 78628-5333
(216) 513-2236

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34.008507
OH
207P00000X
Emergency Medicine Physician
Primary
R5027
TX

Other

Enumeration date
06/06/2007
Last updated
11/26/2018
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