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NPI Code Detail

MEDICARE: DR. RICHARD M. WATSON M.D.

MEDICARE: DR. RICHARD M. WATSON M.D.
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
1207R00000XInternal Medicine Physician25MAO1866700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125MAO1866700OTHERNJMEDICAL LICENSE

General Provider Information

NPI Number : 1811933070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD M. WATSON M.D.
Provider Business Mailing Address
First Line : 14 N GATE RD
Second Line :
City : MENDHAM
State : NJ
Zip : 07945-3105
Country : US
Telephone Number : 973-543-7404
Fax Number : 973-543-0998
Provider Business Practice Location Address
First Line : 17 S WARREN ST
Second Line :
City : DOVER
State : NJ
Zip : 07801-4506
Country : US
Telephone Number : 973-328-3344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/08/2007

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