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NPI Code Detail

MEDICARE: PETER T WATSON MD

MEDICARE: PETER T WATSON 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
1207VM0101XMaternal & Fetal Medicine PhysicianMD11910OR

Other Identifiers

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

General Provider Information

NPI Number : 1750363719
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER T WATSON MD
Provider Business Mailing Address
First Line : 9701 SW BARNES RD
Second Line : SUITE 299
City : PORTLAND
State : OR
Zip : 97225-6772
Country : US
Telephone Number : 503-297-3660
Fax Number : 503-297-7637
Provider Business Practice Location Address
First Line : 9701 SW BARNES RD
Second Line : SUITE 299
City : PORTLAND
State : OR
Zip : 97225-6772
Country : US
Telephone Number : 503-297-3660
Fax Number : 503-297-7637
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 10/12/2007

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