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Individual
SUSAN E WATERS
Active
Individual
SUSAN E WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G43530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G435300
—
CA
Enumeration date
06/26/2006
Last updated
10/23/2008
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