Individual
DR. MARK B. WATERMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(404) 265-4000
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
021214
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00264180
RAILROAD MEDICARE
GA
Enumeration date
06/03/2006
Last updated
07/08/2007
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