Individual
BRIAN S PUTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
32800 LORAIN RD STE 2300, NORTH RIDGEVILLE, OH 44039-3430
(440) 506-5500
Mailing address
6000 W CREEK RD, SUITE 10, INDEPENDENCE, OH 44131-2182
(800) 223-2273
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-082853
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000348339
ANTHEM
OH
05
—
2407274
—
OH
Enumeration date
06/15/2006
Last updated
11/19/2020
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