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NPI Code Detail

MEDICARE: RAMIZ PUTRUS M.D.

MEDICARE:   RAMIZ  PUTRUS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician49570AZ
2207Q00000XFamily Medicine Physician4301061917MI
3207Q00000XFamily Medicine PhysicianA68184CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11059106470OTHERAMERICAN BOARD OF FAMILY MEDICINE

General Provider Information

NPI Number : 1144300534
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAMIZ PUTRUS M.D.
Provider Business Mailing Address
First Line : 116 W 8 MILE RD
Second Line :
City : HAZEL PARK
State : MI
Zip : 48030-2433
Country : US
Telephone Number : 248-541-7606
Fax Number : 248-541-7197
Provider Business Practice Location Address
First Line : 165 S 1ST ST
Second Line :
City : EL CAJON
State : CA
Zip : 92019-4795
Country : US
Telephone Number : 619-312-0347
Fax Number : 619-749-5480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/07/2023

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