Individual provider · Type 1 NPI

Mia Watson, PA-C

Physician Assistant · Philadelphia, PA

NPI number 1083492011 Active

Practice location

12000 Bustleton Ave Ste 102
Philadelphia, PA 19116-2151

Call (215) 673-7600 Map

Fax (215) 673-1894

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XMA065077 (PA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1083492011

Mia Watson, PA-C's National Provider Identifier is 1083492011, issued on Sep 20, 2023. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Philadelphia, PA. The record was last updated on May 12, 2026.