Individual
MICHAEL ROY WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
844 TUCK ST, LEBANON, PA 17042-7477
(717) 639-3915
(717) 639-3960
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 639-3915
(717) 639-3960
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD043820E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00154415
—
PA
01
—
1520834
GATEWAY-WMG
PA
01
—
20069233
AMERIHEALTH MERCY-WMG
PA
01
—
211162
JOHNS HOPKINS
PA
01
—
237440
UNISON-WMG
PA
01
—
50074899
CAPITAL BLUE CROSS-WMG
PA
01
—
7534091
AETNA
PA
01
—
786823
HIGHMARK BLUE SHIELD
PA
01
—
919374
CAREFIRST MD BCBS
MD
Enumeration date
10/05/2005
Last updated
06/21/2021
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