Individual
SURAJ VISHASKHA PUTTANNIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 SPRUCE STREET, PINE BASEMENT WEST, PHILADELPHIA, PA 19107-6130
(215) 829-3264
(215) 829-8044
Mailing address
700 SPRUCE STREET, PINE BASEMENT WEST, PHILADELPHIA, PA 19107-6130
(215) 829-3264
(215) 829-8044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD435456
PA
Other
Enumeration date
12/13/2006
Last updated
03/03/2014
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