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Individual

WILLIAM BRUCE WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 E UNIVERSITY PKWY, BALTIMORE, MD 21218-2829
(410) 554-2107
Mailing address
107 E BURKE AVE, TOWSON, MD 21286-1118
(410) 828-8113

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D54594
MD
207P00000X
Emergency Medicine Physician
MD31689
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010142
MS
01
75859901
BLUE SHIELD
MD
01
75859903
BLUE SHIELD
MD
Enumeration date
11/20/2006
Last updated
02/29/2008
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