FARAD KEITH PRUITT

JACKSON, MI
NPI1912959826
Former NameFARAD KEITH MUHAMMAD
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MI  4301074892)
Enumeration Date2006-05-17
Last Update Date2007-07-08
Business Address
-- FARAD KEITH PRUITT MD
205 N EAST AVE
JACKSON, MI 49201-1753
Phone number: 517-841-1328
Mailing Address
-- FARAD KEITH PRUITT MD
PO BOX 67000 DEPARTMENT 272801
DETROIT, MI 48267-2728
Phone number: 517-841-6913
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