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1275512261

NPI Code Detail

MEDICARE: STEPHANIE W PUTZIER MD

MEDICARE: STEPHANIE W PUTZIER MD

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
1	207R00000X	Internal Medicine Physician	35972	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	110103558	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1966132	OTHER	MN	AMERICAS PPO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0401916	OTHER	MN	MEDICA
4	121151	OTHER	MN	UCARE
5	HP25864	OTHER	MN	HEALTH PARTNERS
6	410849339 56001 C077	OTHER		CHAMPUS
7	NA2951023855	OTHER	MN	PREFERRED ONE
9	1M944PU	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1275512261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE W PUTZIER MD

Provider Business Mailing Address
First Line	:	160 COUNTRY CLUB DR
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-9338
Country	:	US
Telephone Number	:	507-380-3644
Fax Number	:	507-345-1553

Provider Business Practice Location Address
First Line	:	3530 LEXINGTON AVE N
Second Line	:
City	:	SHOREVIEW
State	:	MN
Zip	:	55126-8166
Country	:	US
Telephone Number	:	651-714-0200
Fax Number	:	651-714-0201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	03/13/2024

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Directions to “ STEPHANIE W PUTZIER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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