Individual
DR. MICHAEL B PRUDHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(928) 269-5657
Mailing address
1285 W D ST BLDG U238, NORFOLK, VA 23511-3394
(757) 953-6600
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
01060410A
IN
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
01060410A
IN
208D00000X
General Practice Physician
Primary
36179
AZ
Other
Enumeration date
12/26/2006
Last updated
10/11/2022
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