Individual
JOHN DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
143 HAZELWOOD ST, DETROIT, MI 48202-1771
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601008295
MI
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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