Individual
DR. KENNETH W WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER, 8008 WESTPARK DRIVE, MCLEAN, VA 22102
(703) 489-1405
Mailing address
8008 WESTPARK DRIVE, MAPMG DEPT OF ANESTHESIA, MCLEAN, VA 22102
(703) 489-1405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101252186
VA
207L00000X
Anesthesiology Physician
D0068100
MD
207L00000X
Anesthesiology Physician
EC-05-170
ME
207L00000X
Anesthesiology Physician
MD044841
DC
207L00000X
Anesthesiology Physician
MD17452
ME
Other
Enumeration date
12/01/2006
Last updated
07/23/2021
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