MEDICARE: TINA MARIA PUTMAN

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1124919691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MARIA PUTMAN

Provider Business Mailing Address
First Line	:	603 MACMILLAN DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-2743
Country	:	US
Telephone Number	:	937-672-6977
Fax Number	:	937-672-6977

Provider Business Practice Location Address
First Line	:	603 MACMILLAN DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-2743
Country	:	US
Telephone Number	:	937-672-6977
Fax Number	:	937-672-6977

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

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

Similar Medicare Providers

1306799812 — TAUNDRA DELONEY
Practice Location Address:

545 ODLIN AVE
DAYTON, OH
45405-2743

Practice Phone: 937-604-6376
Practice Fax:

1699167759 — STEAM ACADEMY OF DAYTON
Practice Location Address:

545 ODLIN AVE
DAYTON, OH
45405-2743

Practice Phone: 937-262-7063
Practice Fax:

1023763059 — OPHELIA BEATRICE ROBINSON
Practice Location Address:

4938 MAPLECREEK DR APT B
DAYTON, OH
45426-1662

Practice Phone: 937-271-6240
Practice Fax: 937-271-6240

1275126344 — VONCIEL M. ENGLISH
Practice Location Address:

5161 WELL FLEET DR
DAYTON, OH
45426-1419

Practice Phone: 937-241-0668
Practice Fax: 937-715-4602

1245235845 — EVANGELICAL RETIREMENT VILLAGES,INC. OF DAYTON DBA FRIENDSHIP VILLAGE
Practice Location Address:

5790 DENLINGER RD
DAYTON, OH
45426-1838

Practice Phone: 937-838-5581
Practice Fax: 937-854-8203

1235120361 — THE JEWISH FEDERATION OF GREATER DAYTON
Practice Location Address:

4911 COVENANT HOUSE DR
DAYTON, OH
45426-2007

Practice Phone: 937-837-2651
Practice Fax: 937-837-5831

Directions to “ TINA MARIA PUTMAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.