Physician Compare National (NPI:1093872947)

HEALTHCARE PROVIDER: ERIC T WATERMAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093872947
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052472008
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081209000369
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WATERMAN
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4300 TALBOT RD S
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 311
	Group Practice or individual's line 2 address
City	RENTON
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	980556238
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	500088
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y