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General NPI Number Information
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NPI Number | 1801869243
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Entity Type | Individual
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Provider Name | C CLEVE WATERS MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 1755 GUNBARREL RD SUITE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7137
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Country | US
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Telephone | 423-855-4044
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Fax | 423-855-4105
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Provider Business Mailing Address
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Address Line | 1755 GUNBARREL RD SUITE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7137
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Country | US
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Telephone | 423-855-4044
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Fax | 423-855-4105
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0000011727
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License Number State | TN
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