Individual
DR. KURTIS ALLEN WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13359 ISLE DR, SUITE 1, BAXTER, MN 56425-2221
(218) 454-8888
Mailing address
13359 ISLE DR, SUITE 1, BAXTER, MN 56425-2221
(218) 454-8888
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
37843
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
422K8WA
BLUE CROSS BLUE SHIELD MN
MN
05
—
930218200
—
MN
01
—
P00409713
PALMETTO - RAILROAD MEDICARE
MN
Enumeration date
01/06/2006
Last updated
08/15/2011
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