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1598737843

NPI Code Detail

MEDICARE: TERRI-ANN WATTSMAN MD

MEDICARE: TERRI-ANN WATTSMAN MD

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	208600000X	Surgery Physician	0101-053004	VA
2	208600000X	Surgery Physician	01068504A	IN
3	2086S0120X	Pediatric Surgery Physician	01068504A	IN
4	208600000X	Surgery Physician	0101053004	VA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598737843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI-ANN WATTSMAN MD

Provider Business Mailing Address
First Line	:	102 HIGHLAND AVE SE STE 404
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24013-2232
Country	:	US
Telephone Number	:	540-985-9812
Fax Number	:	540-985-5328

Provider Business Practice Location Address
First Line	:	4348 ELECTRIC RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0720
Country	:	US
Telephone Number	:	540-769-0976
Fax Number	:	540-857-5383

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	09/07/2023

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Directions to “ TERRI-ANN WATTSMAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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