MEDICARE: MICHAEL ROY WATSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	MD043820E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	237440	OTHER	PA	UNISON-WMG
2	50074899	OTHER	PA	CAPITAL BLUE CROSS-WMG
3	7534091	OTHER	PA	AETNA
4	1520834	OTHER	PA	GATEWAY-WMG
5	786823	OTHER	PA	HIGHMARK BLUE SHIELD
6	211162	OTHER	PA	JOHNS HOPKINS
7	919374	OTHER	MD	CAREFIRST MD BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	20069233	OTHER	PA	AMERIHEALTH MERCY-WMG

General Provider Information

NPI Number	:	1689661555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ROY WATSON MD

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-639-3915
Fax Number	:	717-639-3960

Provider Business Practice Location Address
First Line	:	844 TUCK ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7477
Country	:	US
Telephone Number	:	717-639-3915
Fax Number	:	717-639-3960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	06/21/2021

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Directions to “ MICHAEL ROY WATSON MD” Practice Location

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