Individual
DR. BRIAN ROBERT WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 MOONEY ST, WINSTON SALEM, NC 27103-3032
(336) 716-8093
(336) 716-9329
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2017-01397
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2017-01397
NC
Other
Enumeration date
08/05/2007
Last updated
07/21/2022
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