Provider Demographics
NPI:1477577799
Name:WATSON, ERIK N (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:N
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 1:159 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2442
Mailing Address - Country:US
Mailing Address - Phone:508-226-0213
Mailing Address - Fax:508-226-6820
Practice Address - Street 1:159 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2442
Practice Address - Country:US
Practice Address - Phone:508-226-0213
Practice Address - Fax:508-226-6820
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3165043Medicaid
MA000000028114OtherBMC HEALTHNET
MA359OtherFALLON
004263OtherRIBC
0400738OtherUHC
MAB10233201OtherCIGNA
MAJ15756OtherMABC
MA66266OtherHPHC
MA719217OtherTUFTS
MA66266OtherHPHC
E56799Medicare UPIN