MEDICARE: DR. JAMEL N MCDUFFIE-WATSON DDS

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	1223G0001X	General Practice Dentistry	6770	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942387071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMEL N MCDUFFIE-WATSON DDS

Provider Business Mailing Address
First Line	:	6104 FAYETTEVILLE RD
Second Line	:	SUITE 107
City	:	DURHAM
State	:	NC
Zip	:	27713-6283
Country	:	US
Telephone Number	:	919-484-7478
Fax Number	:	919-572-9942

Provider Business Practice Location Address
First Line	:	6104 FAYETTEVILLE RD
Second Line	:	SUITE 107
City	:	DURHAM
State	:	NC
Zip	:	27713-6283
Country	:	US
Telephone Number	:	919-484-7478
Fax Number	:	919-572-9942

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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