Individual
MR. FREDERICK DONALD WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
66 SHERMAN ST APT 3, PORTLAND, ME 04101
(207) 669-5910
Mailing address
66 SHERMAN ST APT 3, PORTLAND, ME 04101-2206
(207) 669-5910
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP131037
ME
Other
Enumeration date
07/22/2013
Last updated
07/13/2018
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