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General NPI Number Information
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NPI Number | 1518945583
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Entity Type | Individual
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Provider Name | CHRISTOPHER ROY WATTERS MD
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Gender | Male
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 1212 CEDARHURST DRIVE SUITE 102
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City | RALEIGH
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State | NC
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Zip | 27609
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Country | US
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Telephone | 919-431-9911
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Fax | 919-850-1397
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Provider Business Mailing Address
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Address Line | 5213 S ALSTON AVE
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City | DURHAM
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State | NC
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Zip | 27713-4430
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Country | US
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Telephone | 919-620-5041
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Fax | 919-620-4921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34194
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License Number State | NC
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