Individual
PAUL S PUTTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
860 SUMMIT CROSSING PL STE 120, GASTONIA, NC 28054-2217
(740) 861-2072
Mailing address
15825 BALLANTYNE MEDICAL PL STE 240, CHARLOTTE, NC 28277-4790
(704) 544-5245
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
AP9426772
NC
208D00000X
General Practice Physician
24284
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2323842
GROUP MEDICARE PTAN
NC
01
—
37011930
MEDICARE RAILROAD PTAN
NC
01
—
DE0112
GROUP MEDICARE RAILROAD PTAN
NC
Enumeration date
03/24/2006
Last updated
10/25/2023
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