Provider Demographics
NPI:1841280252
Name:WATERS, CHESTER HILL III (MD)
Entity type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:HILL
Last Name:WATERS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:11819 MIRACLE HILLS DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4428
Mailing Address - Country:US
Mailing Address - Phone:402-492-9922
Mailing Address - Fax:402-492-9944
Practice Address - Street 1:11819 MIRACLE HILLS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4428
Practice Address - Country:US
Practice Address - Phone:402-492-9922
Practice Address - Fax:402-492-9944
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2007-12-04
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Provider Licenses
StateLicense IDTaxonomies
NE14899207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1599OtherBCBS NE
NE47073160200Medicaid
NE1599OtherBCBS NE
NE47073160200Medicaid