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Individual
CATHY WATERMAN GRACE
Active
Individual
CATHY WATERMAN GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8711
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015351
—
MT
01
—
080148086
RAILROAD MEDICARE
MT
Enumeration date
09/13/2006
Last updated
04/15/2025
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