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General NPI Number Information
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NPI Number | 1821606443
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Entity Type | Individual
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Provider Name | THERESA R WATKINS-BRYANT MD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | HOWARD UNIV HOSPITAL 2041 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20060-0001
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Country | US
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Telephone | 301-775-0206
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 DANWOOD LN
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City | MITCHELLVILLE
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State | MD
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Zip | 20721-3231
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD12667
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License Number State | DC
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