Individual
MICHAEL DALLAS WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
12575 US HIGHWAY 1, STE 200, JUNO BEACH, FL 33408-2477
(561) 284-7899
Mailing address
4952 W LIBERTY PARK CIR, NORTH CHARLESTON, SC 29405-4009
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
999999999
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
999999999
TEST
SC
Enumeration date
10/02/2014
Last updated
10/02/2014
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