Individual
DEBORAH U WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6300
(505) 368-6324
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6300
(505) 368-6324
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
G2241
TX
2081P0004X
Spinal Cord Injury Medicine Physician
G2241
TX
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD039557E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432394
—
AZ
05
—
43280579
—
CO
05
—
Q9896
—
NM
Enumeration date
10/17/2005
Last updated
12/26/2007
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