Individual
PETER PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9930 WATSON RD, SAINT LOUIS, MO 63126-1827
(314) 965-5437
(314) 965-5439
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 965-5437
(314) 965-5439
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
113311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200670
UHC
MO
01
—
143223
BCBS
MO
01
—
23561V3431
HEALTHCARE USA
MO
01
—
431383893PUT
MERCY
MO
01
—
456440
HEALTHLINK
MO
01
—
7432234
AETNA
MO
01
—
96948
GHP
MO
Enumeration date
11/09/2005
Last updated
09/26/2012
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