Doctor Name: | BRENDAN L WATERS |
NPI Number: | 1043200579 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 0102201725 |
Business Practice Address: | 2300 Opitz Blvd Dept Of Radiology Woodbridge, VA - 22191 |
Business Phone Number: | 7036071561 |
Business Fax Number: | |
Mailing Address: | 6 Franklin St, ALEXANDRIA |
State: | VA |
Postal Code: | 223143868 |
Phone Number: | 2154323072 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2005 |
NPI Last Update Date: | 10/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 0102201725 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |