Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tyler Stephen Prusisz, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1295674158

Tyler Stephen Prusisz, MD is a Student in an Organized Health Care Education/Training Program in Charlottesville, Virginia. Licensed in Virginia. Registered with an NPI since 2026.

Licensed in
VA
In the registry since
2026
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1215 Lee St Box 800699
Charlottesville, VA 22908-0816
Phone: (434) 924-8485
Fax: (434) 924-2231
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (VA)

Record details

NPI number1295674158
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 26, 2026
Last updated in NPPESMarch 26, 2026
Certification dateMarch 26, 2026
Mailing address1215 Lee St, Box 800699, Charlottesville, VA 22908-0816

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