Provider Demographics
NPI:1932339025
Name:PUTTA, SWAPNA LAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:SWAPNA
Middle Name:LAKSHMI
Last Name:PUTTA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:55 FOGG ROAD
Mailing Address - Street 2:BWH DEPARTMENT OF NEUROLOGY, EMERSON 150
Mailing Address - City:SOUTH WEUMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190
Mailing Address - Country:US
Mailing Address - Phone:781-624-8197
Mailing Address - Fax:781-624-6735
Practice Address - Street 1:55 FOGG ROAD
Practice Address - Street 2:BWH DEPARTMENT OF NEUROLOGY, EMERSON 150
Practice Address - City:SOUTH WEUMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-624-8197
Practice Address - Fax:781-624-6735
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2015-05-26
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Provider Licenses
StateLicense IDTaxonomies
MA2546632084N0600X
AZR71668390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program