Individual
MICHAEL WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1051 HICKORY ST, MELBOURNE, FL 32901-1962
(321) 784-3700
(321) 784-4090
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
(706) 650-0705
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME60656
FL
Other
Enumeration date
12/18/2006
Last updated
06/05/2008
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