Individual
MR. SHAWN ROBERT PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
440 NEW BRITAIN AVE, PLAINVILLE, CT 06062-2036
(860) 793-0500
(860) 793-1116
Mailing address
1801 ASYLUM AVE, WEST HARTFORD, CT 06117-2602
(860) 793-0500
(860) 793-1116
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
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