Individual
MR. MICHAEL P WATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
50505 SCHOENHERR RD, SUITE 290, SHELBY TWP, MI 48315-3140
(586) 314-0080
(877) 673-3562
Mailing address
50505 SCHOENHERR RD, SUITE 290, SHELBY TWP, MI 48315-3140
(586) 314-0080
(877) 673-3562
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
5601002148
MI
363AM0700X
Medical Physician Assistant
Primary
002148
MI
Other
Enumeration date
07/13/2006
Last updated
03/11/2025
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