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General NPI Number Information
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NPI Number | 1649652280
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Entity Type | Individual
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Provider Name | ANGELA SUHALE PUTHENVEETIL MD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2945 W INA RD STE 215&221
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City | TUCSON
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State | AZ
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Zip | 85741-2350
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Country | US
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Telephone | 520-616-1531
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Fax | 520-616-1536
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | MARANA
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State | AZ
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Zip | 85653-0188
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Country | US
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Telephone | 520-682-4111
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Fax | 520-616-1442
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11018086A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 56136
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License Number State | AZ
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