Individual
ANGELA MARIE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDE
Contact information
Practice address
600 MOYE BLVD, MODULE A, GREENVILLE, NC 27834-4300
(252) 744-1158
(252) 744-1200
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L003338
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19FU0
BCBS OF NC
NC
01
—
Q36656A
MEDICARE PTAN
—
Enumeration date
06/16/2011
Last updated
05/06/2016
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