Provider Demographics
NPI:1740176080
Name:WATTS, ANDREW GEORGE
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:GEORGE
Last Name:WATTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CEDAR BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1330
Mailing Address - Country:US
Mailing Address - Phone:478-230-1765
Mailing Address - Fax:
Practice Address - Street 1:20 CEDAR BLVD STE 204
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1330
Practice Address - Country:US
Practice Address - Phone:412-407-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1064188146N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic