Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101020060 | MI |
NPI | 1053675819 |
---|---|
Provider Name | Dr. Sheila Putman |
First Address | Myrtle Beach, SC 29572 |
Second Address | Myrtle Beach, SC 29572-4621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 06/04/2018 |