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General NPI Number Information
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NPI Number | 1891772737
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Entity Type | Individual
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Provider Name | CHARLES STEPHEN WATRAS MD
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 3765 E US 64 ALT STE 7
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City | MURPHY
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State | NC
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Zip | 28906-6967
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Country | US
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Telephone | 828-835-8733
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Fax | 828-835-8732
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Provider Business Mailing Address
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Address Line | 3765 E US 64 ALT STE 7
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City | MURPHY
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State | NC
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Zip | 28906-6967
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Country | US
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Telephone | 828-835-8733
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Fax | 828-835-8732
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 38238
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD11633
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License Number State | TN
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