Waters, Stanley J
Waters, Stanley J is an sole proprietor health care provider with primary practice located at 1673 Shoreline Dr Ste 100, Boise ID 83702-6736. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Waters, Stanley J can be contacted via phone (208) 322-0485.Contact Information
Primary practice address
1673 Shoreline Dr Ste 100
Boise ID 83702-6736
Phone: (208) 322-0485
Fax: (208) 378-8228
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | M6247 | Idaho |
Profile Details
| NPI number | 1821046335 |
|---|---|
| LBN Legal business name | Waters, Stanley J |
| Credentials | M.D., PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 5th, 2006 |
| Last updated | May 5th, 2015 - about 10 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821046335 | NPPES |
| Idaho | MEDICAID | 000039400 | |
| Idaho | Other | 71928 | |
| Idaho | Other | 000010004618 |
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