Individual
DR. MICHITAKA KAWATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
65773
WI
208600000X
Surgery Physician
MA08835400
NJ
208C00000X
Colon & Rectal Surgery Physician
25MA08835400
NJ
208C00000X
Colon & Rectal Surgery Physician
Primary
65773
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA08835400
STATE LICENSE
NJ
Enumeration date
07/07/2009
Last updated
06/29/2016
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