Provider Demographics
NPI:1053675819
Name:PUTMAN, SHEILA (DO)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:PUTMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1021 CIPRIANA DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572
Mailing Address - Country:US
Mailing Address - Phone:843-449-6449
Mailing Address - Fax:843-449-1069
Practice Address - Street 1:1021 CIPRIANA DR STE 220
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4621
Practice Address - Country:US
Practice Address - Phone:843-449-6449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020060207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery