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Individual

STEFANIE MARIE PUTNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
727 SE MAIN ST, SUITE 300, SIMPSONVILLE, SC 29681-3247
(864) 454-6440
(864) 454-6445
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6044

Taxonomy

Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
29131
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291311
SC
01
SCL4453365
MEDICARE PIN
SC
Enumeration date
09/22/2006
Last updated
12/01/2021
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