Individual
MR. SHAWN ROBERT PUTNAM
Active
Individual
MR. SHAWN ROBERT PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
257127
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033150719
MEDICARE NPI
CT
01
—
3V3059
HEALTHNET PROVIDER #
CT
Enumeration date
06/10/2006
Last updated
01/29/2010
Update your record
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