Individual
JENNIFER J. WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4069 LAKE DR SE, SUITE 114, GRAND RAPIDS, MI 49546-8816
(616) 267-8346
(616) 940-8004
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
LP01109
RI
2086S0129X
Vascular Surgery Physician
Primary
4301101424
MI
Other
Enumeration date
06/01/2007
Last updated
02/19/2021
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