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Individual

DEREK SCOTT WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
727 SE MAIN ST, SUITE 130, SIMPSONVILLE, SC 29681-3247
(864) 454-6560
(864) 454-6565
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19376
SC
2086S0102X
Surgical Critical Care Physician
19376
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
576007863173
BCBS
SC
01
P00392345
RR MEDICARE
SC
05
T33951
SC
Enumeration date
08/29/2006
Last updated
04/11/2022
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