Individual
DR. MICHAEL G WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4944 GREENSBORO RD, RIDGEWAY, VA 24148-3390
(276) 956-2233
(276) 956-1629
Mailing address
142 S MAIN ST, DANVILLE, VA 24541-2922
(434) 797-2828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101045065
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010251001
—
VA
Enumeration date
05/01/2006
Last updated
11/30/2018
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