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DR. COZUMEL SOUTHERN PRUETTE MD MHS NPI 1295887750


NPI Information

NPI: 1295887750
Provider Name: DR. COZUMEL SOUTHERN PRUETTE, MD, MHS
Classification: Pediatrics - 2080P0210X
Entity Type: Individual

Specialization: Pediatric Nephrology

PECOS Registration: Yes

Address:
200 N WOLFE ST
ROOM 3055
BALTIMORE, MD
ZIP 21287
Phone: (410) 955-2467
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DR. Cozumel Southern Pruette, MD, MHS is a pediatric nephrology pediatrics in Baltimore, MD with 19 years of experience. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. DR. Cozumel Southern Pruette, MD, MHS NPI is 1295887750. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2005

The provider's business location address is:

200 N WOLFE ST
ROOM 3055
BALTIMORE, MD
ZIP 21287-011
Phone: (410) 955-2467

The NPI 1295887750 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 3/1/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsP20254MARYLANDNo
22080P0210XPediatricsPediatric NephrologyD67656MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1242766YX1MEDICARE PINMARYLAND
2055174100MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.