Provider Demographics
NPI:1932302312
Name:PUTCHA, NIRUPAMA (MD)
Entity Type:Individual
Prefix:
First Name:NIRUPAMA
Middle Name:
Last Name:PUTCHA
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 1:5501 HOPKINS BAYVIEW CIR RM 4B.74
Mailing Address - Street 2:DIVISION OF PULMONARY AND CRITICAL CARE MEDICINE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-6821
Mailing Address - Country:US
Mailing Address - Phone:410-550-0506
Mailing Address - Fax:410-550-2612
Practice Address - Street 1:5501 HOPKINS BAYVIEW CIR RM 4B.74
Practice Address - Street 2:DIVISION OF PULMONARY AND CRITICAL CARE MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6821
Practice Address - Country:US
Practice Address - Phone:410-550-0506
Practice Address - Fax:410-550-2612
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190466207R00000X
MDD73193207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD081148300Medicaid
MD363810YVBMedicare PIN