Individual
DR. LAWRENCE B PRUSSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6900 ORCHARD LAKE RD, STE 306, WEST BLOOMFIELD, MI 48322-3405
(248) 855-6663
(248) 855-7546
Mailing address
6900 ORCHARD LAKE RD, STE 311, WEST BLOOMFIELD, MI 48322-3405
(248) 855-6663
(248) 855-7546
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301043881
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2722284
—
MI
Enumeration date
09/13/2005
Last updated
01/03/2008
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