Individual
DR. MICHAEL K WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
179 N BROAD ST, NORWICH, NY 13815-1019
(607) 337-7045
Mailing address
104 SHARMAN DR, NORWICH, NY 13815-3183
(607) 334-7149
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
190029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01349499
—
NY
Enumeration date
10/18/2006
Last updated
07/08/2007
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