Provider Demographics
NPI:1992884712
Name:WATKINS, MONICA DENISE (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISE
Last Name:WATKINS
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 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-3497
Practice Address - Fax:301-896-7399
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0436522085N0700X
MDD00625912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKA80OtherB/C B/S
MD410199500Medicaid
MDJ062OtherB/C B/S
DC2849OtherB/C B/S
MDJ062OtherB/C B/S
MDKA80OtherB/C B/S
DCG00000 019325A00Medicare ID - Type UnspecifiedLOCALITY/JURIS 02 DC/DE
MDCN2566Medicare ID - Type UnspecifiedRAILROAD MEDICARE
DC2849OtherB/C B/S
MDI52058Medicare UPIN
MD435LN832Medicare ID - Type UnspecifiedLOCALITY/JURIS CODE 02