MEDICARE: GREGORY A WATTS 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	207KA0200X	Allergy Physician	35048999	OH

General Provider Information

NPI Number	:	1730180209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY A WATTS M.D.

Provider Business Mailing Address
First Line	:	29001 CEDAR RD
Second Line	:	SUITE 429
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4062
Country	:	US
Telephone Number	:	440-461-5300
Fax Number	:	440-461-7984

Provider Business Practice Location Address
First Line	:	29001 CEDAR RD
Second Line	:	SUITE 429
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4062
Country	:	US
Telephone Number	:	440-461-5300
Fax Number	:	440-461-7984

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	04/11/2008

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