Healthcare Provider Details

I. General information

NPI: 1750441150
Provider Name (Legal Business Name): ALAN C. WATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRY FORD HEALTH SYSTEM ONE FORD PLACE
DETROIT MI
48202
US

IV. Provider business mailing address

HENRY FORD HEALTH SYSTEM ONE FORD PLACE
DETROIT MI
48202
US

V. Phone/Fax

Practice location:
  • Phone: 313-876-2526
  • Fax:
Mailing address:
  • Phone: 313-876-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301033977
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301033977
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301033977
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: