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Individual

DR. ELLIOT D. WATERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
426 SCRABBLETOWN RD, SUITE A, NORTH KINGSTOWN, RI 02852-3649
(401) 295-7339
(401) 295-7311
Mailing address
426 SCRABBLETOWN RD, SUITE A, NORTH KINGSTOWN, RI 02852-3649
(401) 295-7339
(401) 295-7311

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTG-397
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003167
BLUE CHIP
RI
01
201435548
TRICARE
RI
01
2200506
UNITED HEALTH CARE
RI
01
27923-5
BLUE CROSS/BLUE SHIELD
RI
05
9003840
RI
Enumeration date
09/20/2006
Last updated
07/08/2007
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