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Individual

JOHN A WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5055 W BRISTOL RD, FLINT, MI 48507-2922
(810) 732-2272
(810) 732-8470
Mailing address
5055 W BRISTOL RD, FLINT, MI 48507-2922
(810) 732-2272
(810) 732-8470

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
382908096
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180250173
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/31/2006
Last updated
08/12/2010
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