Provider Demographics
NPI:1881781615
Name:ORTIZ, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:46 SWEDEN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2081
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:46 SWEDEN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2081
Practice Address - Country:US
Practice Address - Phone:207-999-1180
Practice Address - Fax:413-794-1629
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA156739207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG90403Medicare UPIN