Provider Demographics
NPI:1376528687
Name:WATSON, PETER ROBINS (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ROBINS
Last Name:WATSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE N
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1584
Mailing Address - Country:US
Mailing Address - Phone:252-559-2200
Mailing Address - Fax:252-522-9778
Practice Address - Street 1:313 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501
Practice Address - Country:US
Practice Address - Phone:252-559-2201
Practice Address - Fax:252-559-2219
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28446207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110038739OtherRAILROAD MEDICARE
NC8985999Medicaid
NC8985999Medicaid
110038739OtherRAILROAD MEDICARE