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Individual

DR. MICHAEL A WATTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2963 E COPPER POINT DR, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731
Mailing address
2963 E COPPER POINT DR, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
EC-06-1097
ME
207P00000X
Emergency Medicine Physician
Primary
M-11231
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M-11231
LICENSE
ID
Enumeration date
12/01/2006
Last updated
09/12/2011
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