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Individual

CONNOR ANDREW WATHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
593 EDDY STREET, APC 6, PHILADELPHIA, RI 02903-4923
(401) 793-9166
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD20205
RI
390200000X
Student in an Organized Health Care Education/Training Program
PA

Other

Enumeration date
04/22/2018
Last updated
06/06/2025
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