DR. COZUMEL SOUTHERN PRUETTE


Address: 200 N Wolfe St, Room 3055, Baltimore, MD 21287-0011
Phone: 4109552467

DR. COZUMEL SOUTHERN PRUETTE (NPI# 1295887750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295887750
Entity Type Individual
Full Name DR. COZUMEL SOUTHERN PRUETTE
Other Name DR. COZUMEL ALLYSON SOUTHERN
Credential MD, MHS
Practice Address 200 N Wolfe St
Room 3055
Baltimore
MD 21287-0011
Mailing Address Po Box 64316
Baltimore
MD 21264-4316
Practice Telephone 4109552467
Mailing Telephone 4109554427
Enumeration Date 2007-01-17
Last Update Date 2013-03-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208000000X Pediatrics P20254 MD Allopathic & Osteopathic Physicians
Y 2080P0210X Pediatrics
Specialization: Pediatric Nephrology
D67656 MD Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MD 055174100 05

Office Location

Street Address 200 N WOLFE ST
ROOM 3055
City BALTIMORE
State MD
Zip Code 21287-0011

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912979196 Carl E Stafstrom Pediatrics 200 N Wolfe St, Baltimore, MD 21287-0011 2006-02-02
1528537305 Oren Gordon Student in an Organized Health Care Education/Training Program 200 N Wolfe St, Baltimore, MD 21287-0011 2018-11-21
1285155333 Kelsey Stauff Student in an Organized Health Care Education/Training Program 200 N Wolfe St, Baltimore, MD 21287-0011 2017-06-29
1518403245 Donna Shatzer Nurse Practitioner 200 N Wolfe St, Baltimore, MD 21287-0011 2017-01-19
1922461714 Jacquelyn Manfredo Student in an Organized Health Care Education/Training Program 200 N Wolfe St, Baltimore, MD 21287-0011 2016-03-30
1659753903 Amanda Regina Wood Nurse Practitioner 200 N Wolfe St, Suite 2158, Baltimore, MD 21287-0011 2015-06-23
1871970301 Mark Porter Student in an Organized Health Care Education/Training Program 200 N Wolfe St, Baltimore, MD 21287-0011 2015-05-05
1841600087 Francis Tintani Student in an Organized Health Care Education/Training Program 200 N Wolfe St, Suite 2-111, Baltimore, MD 21287-0011 2014-04-28
1861819039 Brandon Michael Smith Pediatrics 200 N Wolfe St, Baltimore, MD 21287-0011 2014-03-25
1437418670 Tierra D. Burrell Pediatrics 200 N Wolfe St, Baltimore, MD 21287-0011 2012-05-09
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174140503 Thomas Dimitrios Zaikos Student in an Organized Health Care Education/Training Program Pathology Building Rm. 401, 600 N. Wolfe Street, Baltimore, MD 21287 2020-07-01
1316572175 Sarah Branigan Pediatrics Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD 21287 2020-03-11
1790318657 Margaret Geraldine Keane Internal Medicine Sheikh Zayed Tower, 1800 Orleans St, Baltimore, MD 21287 2020-02-19
1699322636 Lakeya Mcgill Student in an Organized Health Care Education/Training Program 600 North Wolfe St, Phipps 174, Baltimore, MD 21287 2019-08-23
1245882406 Ranim Amer Ibrahim Alsaad Student in an Organized Health Care Education/Training Program 1800 Orleans Street - Johns Hopkins Hospital, Tower 110, Baltimore, MD 21287 2019-07-09
1992364004 Anthony David Pisaniello Student in an Organized Health Care Education/Training Program 1800 Orleans St, Johns Hopkins Hospital, Baltimore, MD 21287 2019-06-12
1255990503 Ethan Tumarkin Student in an Organized Health Care Education/Training Program 600 N. Wolfe St./halsted 500, Baltimore, MD 21287 2019-06-11
1629636386 Kathleen Anne Malloy Counselor Jhh 600 N. Wolfe St., Cpp- Meyer 144, Baltimore, MD 21287 2019-05-29
1285298489 Ashleigh Graham Student in an Organized Health Care Education/Training Program Pathology Building, Rm 401, 600 N. Wolfe Street, Baltimore, MD 21287 2019-04-24
1851955066 Seena Tabibi Student in an Organized Health Care Education/Training Program Pathology Department Johns Hopkins University Som, Pathology Building Rm 401, 600 North Wolfe Street, Baltimore, MD 21287 2019-04-24
Find all providers in zip 21287

Taxonomy Information

Taxonomy Code 2080P0210X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Nephrology

Taxonomy Definition

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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275908105 Netanel G. Schwob, M.d.,p.a. Pediatrics 4000 Old Court Rd, Suite 203, Baltimore, MD 21208-2800 2015-12-03
1376898049 Bakri J Alzarka Pediatrics 22 S Greene St # N5w40, Baltimore, MD 21201 2012-07-19
1164582474 Jeffrey J Fadrowski Pediatrics 600 N Wolfe St, Park 335-peds, Baltimore, MD 21287-0005 2006-12-11
1336182286 Barbara A Fivush Pediatrics 601 N Caroline St, Baltimore, MD 21287-0006 2006-06-14
1831131937 Susan Mendley Pediatrics 22 S Greene St, N5w40, Baltimore, MD 21201-1544 2006-06-12
1548212947 Alicia Mallare Neu Pediatrics 601 N Caroline St, Baltimore, MD 21287-0006 2006-05-16
1376530808 Johns Hopkins University Pediatrics 600 N Wolfe St, Baltimore, MD 21287-0005 2005-09-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1629114228 Lorie Benton Smith Pediatrics 8901 Wisconsin Ave, Nnmc, Section of Pediatric Nephrology, Bethesda, MD 20889-0001 2007-01-30
1588683825 Gregory Harron Gorman Pediatrics 8901 Wisconsin Ave, Building 10, Bethesda, MD 20889-0001 2006-07-18
1932177938 Brent Lee Lechner Pediatrics 4301 Jones Bridge Rd, Bethesda, MD 20814-4712 2006-03-08

Competitor

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City BALTIMORE
Zip Code 21287

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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