Individual
DR. ERIKA SANDRA VAN PUTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3405 DALLAS HWY SW STE 300, MARIETTA, GA 30064-6426
(770) 425-5331
(770) 425-0799
Mailing address
3405 DALLAS HWY SW STE 300, MARIETTA, GA 30064-6426
(770) 425-5331
(770) 425-0799
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
055497
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197955033B
—
GA
05
—
197955033C
—
GA
05
—
197955033D
—
GA
Enumeration date
10/18/2006
Last updated
03/03/2014
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