Provider Demographics
NPI:1538487392
Name:WATSON, ALICE J (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:J
Last Name:WATSON
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Gender:F
Credentials:MD, MPH
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:221 LONGWOOD AVENUE
Mailing Address - Street 2:BRIGHAM AND WOMEN'S DERMATOLOGY ASSOCIATES
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-5500
Mailing Address - Fax:
Practice Address - Street 1:221 LONGWOOD AVE
Practice Address - Street 2:BRIGHAM AND WOMEN'S DERMATOLOGY ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5804
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-243640207N00000X
MA257322207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology