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Individual

DR. MICAH M WATTS

Active
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Individual

DR. MICAH M WATTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA10015600
NJ
2085R0202X
Diagnostic Radiology Physician
MD443009
PA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA10015600
NJ
2085R0204X
Vascular & Interventional Radiology Physician
MD443009
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0294187
NJ
01
171293
MEDICARE
NJ
01
771293
NJ MEDICARE
NJ
01
771300
NJ MEDICARE
NJ
01
771305
NJ MEDICARE
NJ
Enumeration date
05/15/2008
Last updated
12/04/2019
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