Individual
SAMUEL GRADY PUTNAM
Active
Individual
SAMUEL GRADY PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
28916
MS
2085R0204X
Vascular & Interventional Radiology Physician
63241
TN
2085R0204X
Vascular & Interventional Radiology Physician
C1-0011573
DE
2085R0204X
Vascular & Interventional Radiology Physician
MD-23034
HI
2085R0204X
Vascular & Interventional Radiology Physician
MD041221E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012723560016
—
PA
01
—
0546464000
AMERIHEALTH/INTERCOUNTY
PA
01
—
1172545
AETNA HMO
PA
01
—
300099781
RRM
PA
01
—
30026885
KEYSTONE MERCY
PA
01
—
710371
HIGHMARK BLUE SHIELD
PA
01
—
7929044
AETNA PPO
PA
01
—
8215722
CIGNA HMO/PPO
PA
Enumeration date
05/05/2006
Last updated
05/06/2025
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