Individual
DR. GARY LEE WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
102 VALLEY RD, MIDDLETOWN, RI 02842-5237
(401) 239-1800
(401) 239-1793
Mailing address
102 VALLEY RD, MIDDLETOWN, RI 02842-5237
(401) 239-1800
(401) 239-1793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
DO01051
RI
207N00000X
Dermatology Physician
Primary
OS005797L
PA
207NS0135X
Procedural Dermatology Physician
OS 4781
FL
Other
Enumeration date
06/30/2006
Last updated
08/24/2021
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