Individual
BLAKE WATTERWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 893-7270
Mailing address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 893-7270
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD474164
PA
Other
Enumeration date
03/24/2013
Last updated
09/10/2021
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