Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD24227 | ME |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 266573 | MA |
NPI | 1568728244 |
---|---|
Provider Name | Colyn Watkins |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 23/02/2021 |