Individual
DR. MICHAEL RICHARD WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DEPT RADIATION ONCOLOGY, LL, SAINT LOUIS, MO 63110-1032
(314) 747-7236
(314) 362-8099
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 747-7236
(314) 362-8099
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2024016804
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200086234
—
MO
Enumeration date
04/16/2019
Last updated
04/17/2025
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