Individual
DR. DAVID C WATERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
315 TURWILL LN, KALAMAZOO, MI 49006-4231
(269) 343-8170
(269) 382-8490
Mailing address
601 JOHN STREET, BOX 42, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101013019
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
5101013019
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153311575
BLUE CROSS BLUE SHIELD
MI
01
—
0M21440047
MEDICARE ADVANTAGE
MI
01
—
1022112
MCLAREN HEALTH PLAN-MEDICAID
MI
01
—
200000001163
PHP
MI
05
—
4844348
—
MI
01
—
7778363
AETNA
MI
01
—
P00357559
RAILROAD MEDICARE
MI
Enumeration date
06/13/2006
Last updated
01/03/2024
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