Provider Demographics
NPI:1831191295
Name:WATT, WILLIAM B (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:WATT
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 1:198 MASSACHUSETTS AVE
Mailing Address - Street 2:#103
Mailing Address - City:N ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4143
Mailing Address - Country:US
Mailing Address - Phone:978-685-7550
Mailing Address - Fax:978-686-5565
Practice Address - Street 1:198 MASSACHUSETTS AVE
Practice Address - Street 2:#103
Practice Address - City:N ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-4143
Practice Address - Country:US
Practice Address - Phone:978-685-7550
Practice Address - Fax:978-686-5565
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50893207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7509OtherNH LICENSE
0005697OtherNHP
976977OtherNETWORK HEALTH
26396OtherAAO HNS
B20283901OtherCIGNA
220688OtherMMS
MA6142079Medicaid
1837570 002OtherCIGNA PAL
J02180OtherBS HMO
19482OtherH PIL
0108532Y0MA01OtherNH BS
11677OtherFALLON
50893OtherMA LICENSE
JO2180OtherBS MA
050893OtherSECURE HORIZ
85670OtherAETNA USHC
85670OtherAETNA USHC
JO2180OtherBS MA
1837570 002OtherCIGNA PAL