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NPI Code Detail

MEDICARE: MARCUS ALAN WATERS

MEDICARE: MARCUS ALAN WATERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1366271454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS ALAN WATERS
Provider Business Mailing Address
First Line : 5982 RHODES RD
Second Line :
City : KENT
State : OH
Zip : 44240-8100
Country : US
Telephone Number : 330-673-1347
Fax Number : 330-678-3677
Provider Business Practice Location Address
First Line : 1605 COUNTY ROAD 1095
Second Line :
City : ASHLAND
State : OH
Zip : 44805-9609
Country : US
Telephone Number : 330-298-8040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 07/29/2024

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Directions to “ MARCUS ALAN WATERS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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