Individual
MR. MICHAEL T WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 BOWERS ST APT 610, LOWELL, MA 01854-3581
(978) 771-5575
Mailing address
6225 SMITH AVE STE 1001A, BALTIMORE, MD 21209-3626
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
201574
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201574
TRANSFORMATION CENTER BOSTON
MA
05
—
201574
—
MA
Enumeration date
05/14/2021
Last updated
05/14/2021
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