Individual
BRUCE G DECKINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8872 DEER RUN, PETOSKEY, MI 49770-8593
(231) 347-7681
Mailing address
8872 DEER RUN, PETOSKEY, MI 49770-8593
(231) 347-7681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MI43030312
MI
Other
Enumeration date
09/05/2007
Last updated
08/20/2008
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