Individual provider · Type 1 NPI
Daniel John Wattendorf, MD
Clinical Cytogenetics Physician · Keesler Afb, MS
NPI number
1760496178
Active
Practice location
301 Fisher St, Rm 1A132
Keesler Afb, MS 39534-2159
Fax (228) 377-6304
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | MD067656L (PA) |
| Clinical Cytogenetics Physician Primary | 207SC0300X | MD067656L (PA) |
| Clinical Genetics (M.D.) Physician | 207SG0201X | MD067656L (PA) |
Clinical Cytogenetics Physician: A clinical cytogeneticist demonstrates competence in providing laboratory diagnostic and clinical interpretive services dealing with cellular components, particularly chromosomes, associated with heredity.
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About NPI 1760496178
Daniel John Wattendorf, MD's National Provider Identifier is 1760496178, issued on Jul 28, 2006. The primary taxonomy on file is Clinical Cytogenetics Physician (207SC0300X), and the practice location is in Keesler Afb, MS. The record was last updated on Sep 11, 2025.