Individual
VENKATA PUTTAGUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 E MICHIGAN AVE, GRAYLING, MI 49738-1312
(989) 348-5461
Mailing address
PO BOX 545, GRAYLING, MI 49738-0545
(989) 348-1040
(989) 348-0059
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301041328
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4526755
—
MI
Enumeration date
09/04/2006
Last updated
07/09/2007
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