Individual
GARY EDWARD DECESARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1405 COWART ST STE 201, CHATTANOOGA, TN 37408-1178
(423) 220-3596
Mailing address
1405 COWART ST STE 201, CHATTANOOGA, TN 37408-1178
(423) 220-3596
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
88698
GA
208200000X
Plastic Surgery Physician
ME123142
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
06/10/2009
Last updated
04/29/2026
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