Dr. Cozumel Southern Pruette

MD, MHS | Pediatric Nephrology | Female

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Complete Profile:

Dr. Cozumel Southern Pruette basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Nephrology
Provider Name :	Dr. Cozumel Southern Pruette
Other Name :	Cozumel Allyson Southern
Credential :	MD, MHS
Gender :	Female

Business Address:

Dr. Cozumel Southern Pruette address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	200 N Wolfe St, Room 3055 Baltimore, MD, 21287-0011 United States
Phone Number :	410-955-2467

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1295887750
NPI Entity Type :	Individual
First Enrolment Date :	17 Jan, 2007
Last Updated On :	01 Mar, 2013

Medicare Participation:

Dr. Cozumel Southern Pruette participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	5092971119
Medicare Enrollment ID :	I20120718000175
Primary Specialty :	Pediatric Medicine
Medical School :	Southern Illinois University School Of Medicine
Graduation Year :	2005
Accepts Medicare?	Yes. Dr. Cozumel Southern Pruette accepts medicare insurance.

Group Practice Association:

Dr. Cozumel Southern Pruette is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Cozumel Southern Pruette is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Johns Hopkins University	8921903147	2600	4940 Eastern Ave Baltimore, MD - 212242735	Yes
Johns Hopkins University	8921903147	2600	600 N Wolfe St Baltimore, MD - 212870005	Yes
Johns Hopkins University	8921903147	2600	600 N Wolfe St Blalock 266 Baltimore, MD - 212870005 Ph: 4105024340	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Cozumel Southern Pruette are as mentioned. Primary taxonomy code for Dr. Cozumel Southern Pruette, MD, MHS is 2080P0210X (Pediatrics Pediatric Nephrology).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	P20254	MD
2080P0210X	Pediatrics Pediatric Nephrology	Yes	D67656	MD

Legacy Identifiers:

Other legacy medical identifiers of Dr. Cozumel Southern Pruette such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
055174100	MEDICAID	MD

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 64316 Baltimore, MD, 21264-4316 United States
Phone Number :	410-955-4427

Business Location:

Patients can refer following map for directions to Dr. Cozumel Southern Pruette practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.