Waters, Mark

Waters, Mark is an individual health care provider with primary practice located at 2600 Old Washington Rd , Upper St Clair PA 15241-2524. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Waters, Mark can be contacted via phone (412) 854-3627.

Contact Information

Primary practice address
2600 Old Washington Rd Upper St Clair PA 15241-2524
Phone: (412) 854-3627
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD045454L Pennsylvania

Profile Details

NPI number 1104813096
LBN Legal business name Waters, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated May 30th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104813096 NPPES
Pennsylvania MEDICAID 1280366

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