Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E4984 | CA |
N | 222Z00000X | Podiatrist | E4984 | CA |
Y | 213E00000X | Podiatrist | POD001205 | GA |
Y | 222Z00000X | Podiatrist | POD001205 | GA |
NPI | 1053684399 |
---|---|
Provider Name | Dr. Elizabeth Anne Putnam |
First Address | Savannah, GA 31405-4709 |
Second Address | Statesboro, GA 30458-0872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 15/12/2021 |