Putnam, Marshall Edward

Putnam, Marshall Edward is an individual health care provider with primary practice located at 217 Glensford Dr , Fayetteville NC 28314-0892. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Putnam, Marshall Edward can be contacted via phone (910) 483-4647.

Contact Information

Primary practice address
217 Glensford Dr Fayetteville NC 28314-0892
Phone: (910) 483-4647
Fax: (910) 483-6431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 103249 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 103249 North Carolina

Profile Details

NPI number 1962459404
LBN Legal business name Putnam, Marshall Edward
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Dec 10th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962459404 NPPES
North Carolina MEDICAID 8102360

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