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Individual
DR. THEODORE INMAN PUTNAM
Active
Individual
DR. THEODORE INMAN PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
095973
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010142001
UNIVERA
—
01
—
000503501002
BC/BS
—
01
—
000503501004
BC/BS
—
01
—
000503501005
BC/BS
—
05
—
0014382740001
—
PA
05
—
00639423
—
NY
01
—
040426002230
FIDELIS
—
01
—
051028000061
UNIVERA
—
01
—
061102000045
FIDELIS
—
01
—
1211171
IHA
—
Enumeration date
04/18/2006
Last updated
12/16/2008
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