MEDICARE: DR. PATRICE ELAINE WATSON EDD

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1396203865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICE ELAINE WATSON EDD

Provider Business Mailing Address
First Line	:	9701 APOLLO DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4783
Country	:	US
Telephone Number	:	301-245-1882
Fax Number	:	240-334-4848

Provider Business Practice Location Address
First Line	:	9701 APOLLO DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4783
Country	:	US
Telephone Number	:	301-245-1882
Fax Number	:	240-334-4848

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

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	03/04/2019

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