Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | D0086609 | MD |
NPI | 1013370592 |
---|---|
Provider Name | Dr. Jonathan Watson |
First Address | Baltimore, MD 21237 |
Second Address | Baltimore, MD 21237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 22/05/2020 |