Individual
CANDACE SUMMER WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
632 BROADWAY PH, NEW YORK, NY 10012-2614
(800) 731-4254
Mailing address
1209 MOUNTAIN ROAD PL NE STE 5174, ALBUQUERQUE, NM 87110-7845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
151459
AK
207Q00000X
Family Medicine Physician
DR.0074500
CO
207Q00000X
Family Medicine Physician
Primary
MD20221408
NM
207Q00000X
Family Medicine Physician
MD60852613
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2016
Last updated
02/19/2025
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