IndividualActive
Daniel Wattendorf, M.D.
NPI 1760496178 · Clinical Cytogenetics Physician · Keesler Afb, MS
Provider details
- NPI number
- 1760496178
- Entity type
- Individual
- Primary specialty
- Clinical Cytogenetics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD067656L (PA)
Practice location
301 Fisher St
Rm 1a132
Keesler Afb, MS 39534-2159
Phone: (228) 377-6393
Fax: (228) 377-6304
Mailing address
301 Fisher St
Keesler Afb, MS 39534-2159
Registry dates
- Enumerated
- 2006-07-28
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.