Provider Demographics
NPI:1841600178
Name:WATERS, CAITLIN G (MD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:G
Last Name:WATERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:295 VARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2193
Mailing Address - Country:US
Mailing Address - Phone:978-788-7374
Mailing Address - Fax:978-788-7977
Practice Address - Street 1:20 RESEARCH PL STE 310
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2455
Practice Address - Country:US
Practice Address - Phone:978-459-2152
Practice Address - Fax:978-452-7285
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MA277373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program