Individual
MS. BROOKE ELIZABETH WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5500 FRONT ST STE 260, SUMMERVILLE, SC 29486-8140
(843) 576-0700
(843) 576-0701
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3386PA
—
SC
Enumeration date
09/25/2018
Last updated
06/15/2022
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