# SAMUEL GRADY PUTNAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023066404
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | 25MA09575600 | NJ | — |
| 2085R0202X | Diagnostic Radiology Physician | C1-0011573 | DE | — |
| 2085R0202X | Diagnostic Radiology Physician | MD041221E | PA | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 25MA09575600 | NJ | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 28916 | MS | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | 63241 | TN | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | C1-0011573 | DE | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | IMLC.MD.61481675 | WA | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | MD-23034 | HI | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | MD041221E | PA | — |

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 10/01/2026