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GARY G WATERS DO

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1043215338

Individual Registrant:
 GARY G WATERS DO
Gender: M
Sole Proprietor

Location and contact information for practice:
151 ANDERSON LN  WATERFORD, OH 45786-5312 US
Tel: 740-984-2332  Fax: 740-984-4435

Contact information for business:
PO BOX 449  MARIETTA, OH 45750-0449 US
Tel: 740-374-4500  Fax: 740-374-5887

Registration Information:
NPI: 1043215338
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
OH34004554
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
OH34004554

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
ANTHEM000000699794OH01
RRMCRP00139412OH01
0042460000WV05
0703939OH05
ANTHEM000000557176OH01




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