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Individual
MR. HARVEY WILLIS PUTNAM JR.
Active
Individual
MR. HARVEY WILLIS PUTNAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1074
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0827PA
—
SC
01
—
19CQ2
BCBS NC
NC
01
—
7736884
AETNA
SC
01
—
80026764
SELECT HEALTH
SC
05
—
8103265
—
NC
01
—
933312
WELLCARE
SC
01
—
P01210111
RAILROAD MCR
SC
Enumeration date
05/17/2006
Last updated
07/15/2015
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