Individual
PETER MILES WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 E SOUTHERN AVE, STE 102, TEMPE, AZ 85282-7510
(480) 820-9141
(480) 820-3785
Mailing address
DEPT# 42065 PO BOX 650823, DALLAS, TX 75265
(469) 998-7443
(469) 649-0764
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19293
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358996
—
AZ
Enumeration date
11/09/2005
Last updated
03/18/2020
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