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Individual

MR. WILLIAM ROBERT DECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1195 WILSON NW, GRAND RAPIDS, MI 49534-6404
(616) 453-8277
(616) 453-2002
Mailing address
5175 PLAINFIELD NE, GRAND RAPIDS, MI 49525-1048
(616) 453-0294
(616) 726-1492

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901000997
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1266510001
ADMINISTAR
MI
05
3506776
MI
01
480026385
RAILROAD MEDICARE
MI
Enumeration date
06/29/2006
Last updated
11/10/2014
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