Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 12907 | SC |
NPI | 1053386995 |
---|---|
Provider Name | Dr. Stephen W. Watson |
First Address | Columbia, SC 29203-6886 |
Second Address | Columbia, SC 29203-7516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 16/07/2007 |