| Doctor Name: | DR. MARK DAVID WATANABE |
| NPI Number: | 1104020841 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHARMD, PHD |
| License Number: | 37324 |
| Business Practice Address: | 333 South St Shrewsbury, MA - 015457807 |
| Business Phone Number: | 5088564570 |
| Business Fax Number: | |
| Mailing Address: | Po Box 990045, BOSTON |
| State: | MA |
| Postal Code: | 021990045 |
| Phone Number: | 6172650052 |
| Fax Number: | |
| NPI Enumeration Date: | 06/14/2007 |
| NPI Last Update Date: | 01/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P1300X |
| License Number: | 37324 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Psychiatric |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |