Provider Demographics
NPI:1922289800
Name:JARED PUTNAM, MD
Entity Type:Organization
Organization Name:JARED PUTNAM, MD
Other - Org Name:JARED PUTNAM, MD LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:RANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-650-6334
Mailing Address - Street 1:5530 WISCONSIN AVE STE 1255
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4312
Mailing Address - Country:US
Mailing Address - Phone:240-483-0075
Mailing Address - Fax:301-718-3933
Practice Address - Street 1:5530 WISCONSIN AVE STE 1255
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4312
Practice Address - Country:US
Practice Address - Phone:240-483-0075
Practice Address - Fax:301-718-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01235Medicare PIN
MDG01235Medicare PIN