Organization
MOES - WESTERVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY H DECKER MD (PRESIDENT)
(800) 424-3672
Entity
Organization
Contact information
Practice address
300 POLARIS PKWY, WESTERVILLE, OH 43082-7989
(614) 533-3000
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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