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Individual
JOSEPH VANDEWATER
Active
Individual
JOSEPH VANDEWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
022658
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
022658
GA
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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