Provider Demographics
NPI:1750479655
Name:PUTNAM, DEBORAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2150
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:888 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-522-3781
Practice Address - Fax:808-522-4062
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-1879207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC98612Medicare UPIN