Individual
CANDACE R. POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429
(937) 298-4331
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.135122
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14422415
—
OH
Enumeration date
04/09/2014
Last updated
06/18/2019
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