MARK PRUITT, D.O.

Emergency Medicine

Active Individual
NPI: 1124432943

Practice Address

6640 KANIKSU ST
Bonners Ferry, ID 83805

Phone: (208) 267-3141

Specialties

Specialty Code Primary License
Emergency Medicine 207P00000X Yes O-1105 (ID)

Frequently Asked Questions

NPI 1124432943 is the National Provider Identifier for MARK PRUITT, D.O., a Emergency Medicine provider located in Bonners Ferry, ID. This NPI was enumerated on June 19, 2014.
MARK PRUITT, D.O. practices at 6640 KANIKSU ST, Bonners Ferry, ID 83805.

Quick Facts

NPI
1124432943
Type
Individual
Enumerated
Jun 19, 2014
Last Updated
Jun 25, 2019

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