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Individual

DR. CHRISTOPHER ANTHONY DECOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103
(701) 364-3000
(701) 364-8907
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 234-3516

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
12911
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18298
ND
Enumeration date
04/16/2008
Last updated
07/18/2018
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