Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 0101043916 | VA |
NPI | 1013217207 |
---|---|
Provider Name | Dr. Mary Elizabeth Watson |
First Address | Portsmouth, VA 23708-2197 |
Second Address | Portsmouth, VA 23708-2197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2010 |
Last Update Date | 22/10/2010 |