Individual
THADDEUS PATRICK WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 MAIN ST, BUFFALO, NY 14203-1009
(716) 323-0615
Mailing address
8869 LAKE GLEN CT, CLARENCE CENTER, NY 14032-9406
(216) 258-4294
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35089915
OH
207VM0101X
Maternal & Fetal Medicine Physician
036131903
IL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
314132
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3068782
—
OH
Enumeration date
06/18/2007
Last updated
11/21/2022
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