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General NPI Number Information
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NPI Number | 1881970523
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Entity Type | Organization
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Legal Business Name | RAMIZ S. PUTRUS, M.D., P.C.
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 4600 E 14 MILE RD
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City | WARREN
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State | MI
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Zip | 48092-4369
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Country | US
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Telephone | 248-379-4040
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Fax | 586-274-3411
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Provider Business Mailing Address
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Address Line | 4600 E 14 MILE RD
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City | WARREN
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State | MI
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Zip | 48092-4369
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Country | US
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Telephone | 248-379-4040
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Fax | 586-274-3411
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAMIZ S PUTRUS
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Credential | M.D.
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Telephone | 248-379-4040
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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 | 430106197
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License Number State | MI
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