Candace C Green, M.D.

Individual provider Active NPI Obstetrics Physician · Richland, WA

NPI 1154313674 · NPPES record last updated Nov 1, 2016

Key facts

NPI
1154313674
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics Physician 207VX0000X
License
4301073070 (MI)
Practice address
2630 N Columbia Center Blvd
Suite B
Richland, WA 99352-4853
Phone
(509) 420-5053
Fax
(509) 492-5537
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Cities Community Health Past Accepting new patients
Carson City Center for Women'S Healthcare PC Past Accepting new patients
Fauster Cameron Inc. Past Accepting new patients
Tri-Cities Community Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 4301073070 MI Yes

Addresses

Primary practice location

2630 N Columbia Center Blvd
Suite B
Richland, WA 99352-4853

Mailing address

2630 N Columbia Center Blvd
Suite B
Richland, WA 99352-4853
Phone (509) 420-5053

Other identifiers

IdentifierTypeStateIssuer
0700410OtherMIPHP
1605910202OtherMIBCBS
4706065MedicaidMI
4709343MedicaidMI
4706056MedicaidMI

Other names

  • Candace C Green Professional name

Other providers in Richland, WA

All providers in Richland, WA · Obstetrics Physician in Washington

Sources for this page

Verify at the official NPI Registry.