Individual
COURTNEY A WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
36622 FIVE MILE RD STE 101, LIVONIA, MI 48154-1900
(734) 542-0200
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006492
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12454283
CAQH
—
Enumeration date
09/18/2012
Last updated
06/20/2024
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