Waterstone Clinic P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WATERSTONE CLINIC P.C.

Practice address

314 W Superior St
Suite 902
Duluth, MN 55802-1805

Phone

(218) 727-4531

Fax

(218) 727-4211

NPI assigned

Mar 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory Peter Bambenek, MD

Title

Medical Director

Phone

(218) 727-4531

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811014806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W SUPERIOR ST",
            "address_2": "SUITE 902",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021805",
            "telephone_number": "218-727-4531",
            "fax_number": "218-727-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W SUPERIOR ST",
            "address_2": "SUITE 902",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021805",
            "telephone_number": "218-727-4531",
            "fax_number": "218-727-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSTONE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAMBENEK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "218-727-4531",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Wasner
• Brian Wasserman, MD
• Christine Bates Wasserman, M.D.
• Waterman Counseling, LLC
• Hannah Waterman, LICSW
• Amy Lynne Watkins, RN
• Andrea M Watson, MD
• Bailey Laurel Watson, DO
• Kimberly Helen Watson, OD
• Nicole Dorothy Watson, MSW, LICSW

• Psychiatry Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.