Individual
GREGORY STIEGLER WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9701192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055V
BCBS
—
05
—
1802845000
—
WV
01
—
20052072
RR MEDICARE
—
01
—
21327
PARTNERS
—
05
—
7309392
—
VA
01
—
73369
MEDCOST
—
01
—
7852406
AETNA
—
05
—
891055V
—
NC
05
—
Q0119D
—
SC
Enumeration date
12/23/2005
Last updated
11/12/2010
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