Provider Demographics
NPI:1215143623
Name:WATT, KATHRYN H (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:H
Last Name:WATT
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 1:2 HAMILL RD
Mailing Address - Street 2:133 WEST QUADRANGLE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:410-323-5010
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL RD
Practice Address - Street 2:133 WEST QUADRANGLE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1806
Practice Address - Country:US
Practice Address - Phone:410-323-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD390952084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4836Medicare UPIN