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Individual

WILSON T WATANABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10300 W CHARLESTON BLVD STE 13-342, LAS VEGAS, NV 89135-1037
(702) 233-9222
(702) 804-1349
Mailing address
PO BOX 371353, LAS VEGAS, NV 89137-1353
(702) 233-9222
(702) 804-1349

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11156
NV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
11156
NV
207RP1001X
Pulmonary Disease Physician
11156
NV

Other

Enumeration date
02/07/2006
Last updated
04/13/2010
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