Individual
DR. JOSHUA ROBERT DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1195 WILSON AVE NW, GRAND RAPIDS, MI 49534-3493
(616) 453-8277
(616) 453-2002
Mailing address
4540 KALAMAZOO AVE SE, KENTWOOD, MI 49508-4625
(616) 281-0666
(616) 281-0752
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002241
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1266510001
ADMINISTAR
MI
01
—
1639341365
RAILROAD MEDICARE
MI
01
—
480026386
RAILROAD MEDICARE
MI
05
—
5494683
—
MI
01
—
OM71140
MEDICARE ID - TYPE UNSPECIFIED
MI
Enumeration date
04/02/2008
Last updated
09/29/2009
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