| Pruchno Medicine, Llc | |
|
202 10th St Se Suite 200 Cedar Rapids IA 52403-2414 | |
| (319) 247-3899 | |
| Not Available |
| Full Name | Pruchno Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 202 10th St Se, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Charles J Pruchno (OWNER / PROVIDER) |
| Authorized Official Contact | 3192473899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pruchno Medicine, Llc Po Box 1112 Cedar Rapids IA 52406-1112 Ph: (319) 247-3899 | Pruchno Medicine, Llc 202 10th St Se Suite 200 Cedar Rapids IA 52403-2414 Ph: (319) 247-3899 |
| NPI Number | 1225433675 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 10/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225433675 | NPI | - | NPPES |
| 1101865 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 27892 (Iowa) | Primary |
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