Diedrich Collins Waterman, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD34481 Issued in SC

Practice address

116 Baskervill Dr
Pawleys Island, SC 29585-6185

Phone

(843) 237-2672

Fax

(843) 237-0369

NPI assigned

Apr 30, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smith Medical Clinic

  • Community Health Clinic/Center
  • Pawleys Island, SC
  • NPI 1043684632
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1598023376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BASKERVILL DR",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856185",
            "telephone_number": "843-237-2672",
            "fax_number": "843-237-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BASKERVILL DR",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856185",
            "telephone_number": "843-237-2672",
            "fax_number": "843-237-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "DIEDRICH",
        "middle_name": "COLLINS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "MD34481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visible Results
• Susan Walden-Cohn, M.D.
• Lewis Darwin Waldrep, RPH
• Walgreen Co
• Stephen Warren, LMT
• Sheryn Waterman, PH.D.
• Katelyn Weyand, PHARMD
• April Nicole Wheeler, COTA/L
• Emma Wheeler, SSP, NCSP, LPES
• Donald Robert Williams, DR OF CHIROPRACTIC

• Gastroenterology Physician in Pawleys Island, SC
• Providers in Pawleys Island, SC by specialty
• Gastroenterology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.