Provider Demographics
NPI:1932261252
Name:PRITCHETT, CEDRIC V (MD)
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:V
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 409992
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-9992
Mailing Address - Country:US
Mailing Address - Phone:904-697-3610
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:13535 NEMOURS PKWY
Practice Address - Street 2:NEMOURS CHILDRENS HOSPITAL
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7402
Practice Address - Country:US
Practice Address - Phone:407-567-4000
Practice Address - Fax:407-567-5924
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095185390200000X
FLME123098207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program