Provider Demographics
NPI:1780046698
Name:WATSON, AMY CHARRON (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:CHARRON
Last Name:WATSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRIDGE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4987
Mailing Address - Country:US
Mailing Address - Phone:603-856-7236
Mailing Address - Fax:603-856-7434
Practice Address - Street 1:22 BRIDGE ST STE 5
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4987
Practice Address - Country:US
Practice Address - Phone:603-856-7236
Practice Address - Fax:603-856-7434
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH21718208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH21718OtherMEDICAL LICENSE