SAMUEL G PUTNAM III (NPI# 1023066404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023066404 |
| Entity Type | Individual |
| Full Name | SAMUEL G PUTNAM III |
| Credential | MD |
| Practice Address |
4755 Ogletown Santon Road Suite 1e20 Newark DE 19718 |
| Practice Telephone | 3027335625 |
| Practice Fax Number | 3027335665 |
| Mailing Telephone | 3027335625 |
| Mailing Fax Number | 3027335665 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
C1-0011573 | DE | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD041221E | PA | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
C1-0011573 | DE | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MD041221E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CIGNA HMO/PPO | 8215722 | 01 |
| PA | KEYSTONE MERCY | 30026885 | 01 |
| PA | AETNA PPO | 7929044 | 01 |
| PA | AETNA HMO | 1172545 | 01 |
| PA | IBC - PC/KHPE | 0546464000 | 01 |
| PA | AMERIHEALTH/INTERCOUNTY | 0546464000 | 01 |
| PA | RRM | 300099781 | 01 |
| PA | 0012723560016 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 710371 | 01 |
| Street Address |
4755 OGLETOWN SANTON ROAD SUITE 1E20 |
| City | NEWARK |
| State | DE |
| Zip Code | 19718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679026272 | Vikashsingh Parshin Rambhujun | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Road, Suite 2875, Newark, DE 19718 | 2016-07-29 |
| 1730536053 | David Nathan Levine | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, Christiana Health Care, Newark, DE 19718 | 2016-05-17 |
| 1831570332 | Waqas Abid | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, S-le45, Newark, DE 19718 | 2015-06-11 |
| 1366886368 | Amanda J Taylor | Family Medicine | 4755 Ogletown Stanton Rd Ste 6e34, Newark, DE 19718 | 2013-04-20 |
| 1114360872 | Kalpana Suresh | Surgery | 4755 Ogletown-stanton Rd., Newark, DE 19718 | 2013-04-12 |
| 1568580769 | Ember L. Crevar | Pediatrics | 4755 Ogletown Stanton Rd., Christiana Care Hospital - Dept. of Pediatrics, Newark, DE 19718 | 2007-03-26 |
| 1336283803 | Kevin William Smallwood | Physician Assistant | 4755 Ogletown-stanton Dr, Suite 1e50, Newark, DE 19718 | 2007-02-17 |
| 1053374181 | Hung Quang Dam | Nuclear Medicine | Nuclear Medicine, 4755 Ogletown-stanton Rd, Newark, DE 19718 | 2006-04-10 |
| 1346211018 | Robert Flinn | Internal Medicine | 4655 Ogletown-stanton Road, Suite 5343, Newark, DE 19718 | 2006-01-30 |
| 1861477390 | Janet G. Dutcher | Nurse Practitioner | 4755 Ogletown - Stanton Road, Room 2990, Newark, DE 19718 | 2005-12-07 |
| Find all providers in zip 19718 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740706175 | Delaware Radiology Associates Pa | Radiology | 6 Omega Dr Bldg L, Newark, DE 19713-2056 | 2017-08-17 |
| 1912133109 | Oluwole Ayodeji Tairu | Radiology | 150 Bergen St Level C, Newark, NJ 07103-2496 | 2009-06-02 |
| 1548435290 | Denis Primakov | Radiology | 4755 Ogletown Stanton Rd Ste 1752, Newark, DE 19718-2200 | 2008-04-24 |
| 1518163773 | Samson Wong | Radiology | 4755 Ogletown Stanton Rd Rm 1752, Newark, DE 19718-6402 | 2007-06-25 |
| 1386864635 | Open Mri & Imaging of Newark | Radiology | 243 Chestnut Street, Newark, NJ 07105-6501 | 2007-04-27 |
| 1194853952 | Anton Grant Delport | Radiology | 4755 Ogletown-stanton, Roadroom 2a00-christiana Hospital, Newark, DE 19718-0001 | 2007-03-01 |
| 1316028665 | Edward A Del Grosso | Radiology | 1320 W. Main Street, Newark, OH 43055-1822 | 2006-10-17 |
| 1720172885 | Delaware Womens Imaging LLC | Radiology | J-24 Omega Drive, Newark, DE 19713 | 2006-10-03 |
| 1659484467 | An Open Mri Imaging of Newark, LLC | Radiology | 243 Chestnut St., Newark, NJ 07105-6501 | 2006-08-16 |
| 1083645394 | Helen Sax | Radiology | J24 Omega Drive, Newark, DE 19713-2060 | 2006-07-05 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.