Individual
DR. RAQUEL MARIA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5300 MEMORIAL DR STE 121, STONE MOUNTAIN, GA 30083-3154
(404) 254-4500
(404) 254-4517
Mailing address
142 WATERS EDGE DR, LIZELLA, GA 31052-3629
(478) 744-9920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032674
GA
207QA0401X
Addiction Medicine (Family Medicine) Physician
032674
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449721S
—
GA
Enumeration date
07/20/2005
Last updated
03/17/2018
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