Provider Demographics
NPI:1942228960
Name:PUTMAN, CHRISTOPHER M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:PUTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4420
Mailing Address - Country:US
Mailing Address - Phone:703-698-4444
Mailing Address - Fax:703-204-0116
Practice Address - Street 1:4201 TORRANCE BLVD STE 520
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4525
Practice Address - Country:US
Practice Address - Phone:424-212-5361
Practice Address - Fax:310-316-3466
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012314842085B0100X, 2085N0700X, 2085N0904X, 2085P0229X, 2085R0202X, 2085R0204X, 2085U0001X
CAC1548452085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0061OtherCAREFIRST
VA300002549Medicare PIN
VAF92517Medicare UPIN
DC008239F43Medicare PIN
VA0061OtherCAREFIRST