Individual
PETER PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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