Individual
RENEE LATRESE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3651 DAWSON FOREST RD E, SUITE 100, DAWSONVILLE, GA 30534-0404
(706) 216-7337
(770) 783-8899
Mailing address
3651 DAWSON FOREST RD E, SUITE 100, DAWSONVILLE, GA 30534-0404
(706) 216-7337
(770) 783-8899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
035782
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000650339D
—
GA
Enumeration date
03/15/2006
Last updated
10/30/2011
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