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Individual
ETHAN FREDERICK STORTZ
Active
Individual
ETHAN FREDERICK STORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
64599
MN
207RA0401X
Addiction Medicine (Internal Medicine) Physician
DR.0065671
CO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
DR.0065671
CO
Other
Enumeration date
04/12/2017
Last updated
07/23/2024
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