Individual
THEODORE LOUIS WATKINS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
323 15TH ST NE, WASHINGTON, DC 20002-6501
(202) 388-0992
(240) 331-1090
Mailing address
3834 GATEWAY TER, BURTONSVILLE, MD 20866-2107
(240) 462-4785
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
33780
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7177312333
—
DC
Enumeration date
07/19/2006
Last updated
07/08/2007
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