Individual
PRADEEP PUTLUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5841
(763) 780-9155
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
107806
MN
207R00000X
Internal Medicine Physician
50167
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34918700
—
WI
Enumeration date
07/24/2007
Last updated
11/29/2021
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