Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0101268698 | VA |
N | 207X00000X | Orthopaedic Surgeon | 2009-00258 | NC |
N | 207X00000X | Orthopaedic Surgeon | 34377 | SC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2009-00258 | NC |
NPI | 1043369853 |
---|---|
Provider Name | Dr. Ryan Michael Putnam |
First Address | Belfast, ME 04915-4473 |
Second Address | Roanoke, VA 24016-4955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 12/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
343774 | (05) | SC |
5911759 | (05) | NC |