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Individual

STEPHANIE W PUTZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3530 LEXINGTON AVE N, SHOREVIEW, MN 55126-8166
(651) 714-0200
(651) 714-0201
Mailing address
160 COUNTRY CLUB DR, MANKATO, MN 56001-9338
(507) 380-3644
(507) 345-1553

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35972
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0401916
MEDICA
MN
01
110103558
RR MEDICARE
01
121151
UCARE
MN
01
1966132
AMERICAS PPO
MN
01
1M944PU
BCBS
MN
01
410849339 56001 C077
CHAMPUS
05
958583400
MN
01
HP25864
HEALTH PARTNERS
MN
01
NA2951023855
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
03/13/2024
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