MEDICARE: DR. CAROL ELIZABETH WATKINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	D0028738	MD

General Provider Information

NPI Number	:	1255489456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL ELIZABETH WATKINS M.D.

Provider Business Mailing Address
First Line	:	16829 YORK RD
Second Line	:	P.O. BOX 544
City	:	MONKTON
State	:	MD
Zip	:	21111-1020
Country	:	US
Telephone Number	:	410-329-2028
Fax Number	:	410-343-1272

Provider Business Practice Location Address
First Line	:	16829 YORK RD
Second Line	:
City	:	MONKTON
State	:	MD
Zip	:	21111-1020
Country	:	US
Telephone Number	:	410-329-2028
Fax Number	:	410-343-1272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	07/08/2007

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