Individual
MR. THOMAS MICHAEL TRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
504 WILBORN AVE, SOUTH BOSTON, VA 24592-3120
(434) 572-6935
(434) 572-4827
Mailing address
2232 WILBORN AVE, STE B, SOUTH BOSTON, VA 24592-1662
(434) 572-5260
(434) 575-0862
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0101054633
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007107072
—
VA
01
—
435519
ANTHEM
VA
01
—
89150
SENTARA
VA
Enumeration date
06/16/2005
Last updated
09/22/2010
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