Individual
CANDICE E ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-7567
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(877) 845-2926
(207) 777-5363
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
042-0009723
VT
2085U0001X
Diagnostic Ultrasound Physician
042-0009723
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1813
—
VT
Enumeration date
09/22/2006
Last updated
07/21/2022
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