Organization
ROBERT E. DECK, III O.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E. DECK III O.D. (PRESIDENT)
(248) 693-2321
Entity
Organization
Contact information
Practice address
81 INDIANWOOD RD, SUITE 1, LAKE ORION, MI 48362-1595
(248) 693-2321
(248) 693-2703
Mailing address
81 INDIANWOOD RD, SUITE 1, LAKE ORION, MI 48362-1595
(248) 693-2321
(248) 693-2703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003566
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F36558
BLUE CROSS BLUE SHIELD
MI
05
—
943240332
—
MI
Enumeration date
10/30/2012
Last updated
10/30/2012
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