Provider Demographics
NPI:1013923101
Name:VANDERPUTTEN, CARL JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JOHN
Last Name:VANDERPUTTEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:67 SHAKER RD
Mailing Address - Street 2:STE 8
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-9640
Mailing Address - Country:US
Mailing Address - Phone:207-657-5339
Mailing Address - Fax:207-657-5136
Practice Address - Street 1:100 SOUTH ST
Practice Address - Street 2:HARRINGTON MEMORIAL HOSPITAL
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-8002
Practice Address - Country:US
Practice Address - Phone:508-765-9771
Practice Address - Fax:508-765-3147
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA80946207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine