Individual
MR. BRENDAN CRAINE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8323 QUILL POINT DRIVE, BOWIE, MD 20720-4341
(301) 809-0261
Mailing address
8323 QUILL POINT DR, BOWIE, MD 20720-4341
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001214231
VA
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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