Active NPI
Wilson Tatsuo Watanabe, M.D.
- Orthopaedic Surgery Physician
- Chesterfield, SC
National Provider Identifier
1700144417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD6441
- Practice address
- 122 Chester Park Cir
Chesterfield, SC 29709-1009 - Phone
- (843) 623-2687
- NPI assigned
- May 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD6441 | ME | Primary |
Addresses
Primary practice location
122 Chester Park Cir
Chesterfield, SC 29709-1009
Mailing address
122 Chester Park Cir
Chesterfield, SC 29709-1009
Phone (843) 623-2687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD6441 | ME | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335830400000",
"number": "1700144417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 CHESTER PARK CIR",
"city": "CHESTERFIELD",
"state": "SC",
"postal_code": "297091009",
"telephone_number": "843-623-2687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 CHESTER PARK CIR",
"city": "CHESTERFIELD",
"state": "SC",
"postal_code": "297091009",
"telephone_number": "843-623-2687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATANABE",
"first_name": "WILSON",
"middle_name": "TATSUO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-01",
"last_updated": "2012-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "ME",
"license": "MD6441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.