MEDICARE: DR. BARBARA PUTNEY HILDRETH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	14053	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00754316	OTHER	SC	RAILROAD MC ID-RSFPN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P00698095	OTHER	SC	RAILROAD MC ID- 2/16/09-4/30/09

General Provider Information

NPI Number	:	1043275357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA PUTNEY HILDRETH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	843-789-1620
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	5133 RIVERS AVE
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-6338
Country	:	US
Telephone Number	:	843-789-1786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	03/14/2023

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