Provider Demographics
NPI:1154902286
Name:PUTZ, VICTOR (DPM)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:PUTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3592 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-1774
Mailing Address - Country:US
Mailing Address - Phone:989-671-9939
Mailing Address - Fax:
Practice Address - Street 1:3592 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-1774
Practice Address - Country:US
Practice Address - Phone:989-671-9930
Practice Address - Fax:989-671-9901
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901400507213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery