Individual
NICHOLAS GREGORY WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUB IDC
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(904) 680-8007
Mailing address
212 BRUNNERS LN, MONCKS CORNER, SC 29461-8896
(808) 979-5637
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/08/2018
Last updated
05/06/2025
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