Individual
DR. CHANDRA K PUTTAGUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1122 N LEROY ST, FENTON, MI 48430-2789
(810) 629-8303
(810) 629-3949
Mailing address
1122 N LEROY ST, FENTON, MI 48430-2789
(810) 629-8303
(810) 629-3949
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301035890
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3235851
—
MI
Enumeration date
09/02/2006
Last updated
11/20/2011
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