Individual
GARY RAYMOND DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
545 N RIVER ST, SUITE 205, WILKES BARRE, PA 18702-2600
(570) 822-6036
(570) 829-1520
Mailing address
545 N RIVER ST, SUITE 205, WILKES BARRE, PA 18702-2600
(570) 822-6036
(570) 829-1520
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD042296E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012845610001
—
PA
01
—
075321
FIRST PRIORITY HEALTH
PA
01
—
102861
UNISON HEALTH PLAN
PA
01
—
710341
HIGHMARK BLUE SHIELD
PA
01
—
8408
GEISINGER HEALTH PLAN
PA
Enumeration date
05/08/2006
Last updated
11/19/2010
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