Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 9900715 | NC |
N | 111NI0900X | Internist | 9900715 | NC |
Y | 207RR0500X | Rheumatology | 9900715 | NC |
NPI | 1033122668 |
---|---|
Provider Name | Dr. Maria Jeanette Watson |
First Address | Lumberton, NC 28358-3926 |
Second Address | Hope Mills, NC 28348-7525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 03/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1202Y | BLUE CROSS BLUE SHIELD (01) | |
891202Y | (05) | NC |
F66722 | (02) |