Individual
MICHAEL WATA LUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 426-9372
(812) 858-4545
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 450-6879
(812) 858-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01077251A
IN
207R00000X
Internal Medicine Physician
036132602
IL
Other
Enumeration date
07/16/2012
Last updated
09/08/2016
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