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Individual

MICHAEL FARRIS WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 GUSTAVE L LEVY PL FL 12, NEW YORK, NY 10029-6574
(212) 241-7076
Mailing address
2910 N 3RD AVE # 470, PHOENIX, AZ 85013-4434
(602) 406-6262
(602) 406-6261

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
A78335
CA
2084N0400X
Neurology Physician
Primary
327113
NY
2084N0400X
Neurology Physician
52108
AZ
2084N0400X
Neurology Physician
ME86883
FL
2084V0102X
Vascular Neurology Physician
327113
NY
2084V0102X
Vascular Neurology Physician
52108
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279658900
FL
Enumeration date
11/15/2006
Last updated
01/29/2024
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