Individual
DR. TIMOTHY F PRUCHNIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-7000
(207) 973-5042
Mailing address
43 WHITING HILL RD, SUITE 300, BREWER, ME 04412-1005
(207) 973-5035
(207) 973-5042
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
ME0093552
FL
207Q00000X
Family Medicine Physician
44018
KY
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD19592
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000729969
BCBS
KY
01
—
P00974623
RR MEDICARE
KY
Enumeration date
08/09/2005
Last updated
03/13/2013
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