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Individual
TERESSA MCKOY WATTS
Active
Individual
TERESSA MCKOY WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9600299
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003C
NCBCBS
NC
05
—
1932129053
—
NC
05
—
891003C
—
NC
Enumeration date
07/20/2006
Last updated
10/28/2014
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