Individual
LAWRENCE JOSEPH WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-5500
Mailing address
2628 MONROE ST NE, WASHINGTON, DC 20018-2918
(215) 300-3492
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0003373
MD
Other
Enumeration date
02/06/2007
Last updated
01/06/2012
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