Individual
MR. MICHAEL WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
14900 PARK CENTRAL ROAD, NAVAL SUPPORT FACILITY, THURMONT, MD 21788
(301) 271-1460
Mailing address
10384 CHAMBERLIN COURT EAST, WALDORF, MD 20601
(301) 535-7900
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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