Suraj Vishaskha Puttanniah, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD435456 Issued in PA

Practice address

700 Spruce Street
Pine Basement West
Philadelphia, PA 19107-6130

Phone

(215) 829-3264

Fax

(215) 829-8044

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1063573871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "PINE BASEMENT WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3264",
            "fax_number": "215-829-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "PINE BASEMENT WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3264",
            "fax_number": "215-829-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTANNIAH",
        "first_name": "SURAJ",
        "middle_name": "VISHASKHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD435456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashley Purvis, LPC
• Markeitia Purvis, RN
• Tyler Puryear
• Reena Pushpangadan, R.N., J.D.
• Anne Puthettu
• William B. Putterman, O.D.
• Patrycja Puzio, CCC-SLP
• Alissa Rafaella Puzo, MD
• Nicholas Puzzella, OD
• Pvamc

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.