Provider Demographics
NPI:1235175043
Name:PUTHUMANA, LOVEEN (MD)
Entity Type:Individual
Prefix:
First Name:LOVEEN
Middle Name:
Last Name:PUTHUMANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:410-402-2379
Mailing Address - Fax:410-469-3085
Practice Address - Street 1:3110 GRACEFIELD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1820
Practice Address - Country:US
Practice Address - Phone:301-572-8340
Practice Address - Fax:301-572-8403
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059524207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0040OtherBCBS MD
0943ER-628167-01OtherCAREFIRST BCBS OF MD
52-2096682OtherTRICARE NORTH
MD008203102Medicaid
0943SE-628167-01OtherCAREFIRST BCBS OF MD
406491OtherEVERCARE
P16215OtherMPOS
9680-0033OtherCAREFIRST BCBS OF DC
MD403873800Medicaid
628167-01OtherBCBS
52-2096682OtherTRICARE NORTH
0943ER-628167-01OtherCAREFIRST BCBS OF MD
P00189764Medicare PIN