Jason Scott Prudom, M.D. Valid NPI

Individual provider · Pulmonary Disease Physician · Milwaukee, WI

NPI

1265775993

Type

Individual (Type 1)

Primary specialty

Pulmonary Disease Physician (Internal Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207RP1001X

License number

63600-20 (WI)

Sex

Male

Sole proprietor

No

Enumerated

2013-04-01

Last updated

2019-03-25