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Individual

DR. SCOTT ALAN WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
18218 STATE ROAD 37, HARLAN, IN 46743-9609
(260) 657-5159
(260) 657-5150
Mailing address
18218 STATE ROAD 37, HARLAN, IN 46743-9609
(260) 657-5159
(260) 657-5150

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35083455W
OH
207Q00000X
Family Medicine Physician
Primary
IN01052821
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1677841
IN
05
200298440
IN
01
36D1049674
CLIA
IN
Enumeration date
09/12/2006
Last updated
04/01/2024
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