Individual
KEITH FORTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
594 COPENHAGEN RD, WATERFORD, VT 05819-9055
(802) 748-8573
(707) 734-8573
Mailing address
594 COPENHAGEN RD, WATERFORD, VT 05819-9055
(802) 748-8573
(707) 734-8573
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
042-0006155
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007981
—
VT
Enumeration date
08/30/2006
Last updated
01/28/2010
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