Individual
GAVIN PUTHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 1015B, SAINT LOUIS, MO 63141-8232
(314) 251-8965
(314) 251-8966
Mailing address
621 S NEW BALLAS RD, SUITE 1015B, SAINT LOUIS, MO 63141-8232
(314) 251-8965
(314) 251-8966
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2013039277
MO
207V00000X
Obstetrics & Gynecology Physician
27763
NE
Other
Enumeration date
06/25/2010
Last updated
09/01/2015
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