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Individual
DR. CANDACE C GREEN
Active
Individual
DR. CANDACE C GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
4301073070
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700410
PHP
MI
01
—
1605910202
BCBS
MI
05
—
4706056
—
MI
05
—
4706065
—
MI
05
—
4709343
—
MI
Enumeration date
08/19/2005
Last updated
11/01/2016
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