Individual
RAYMOND GERARD DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13911 ST FRANCIS BLVD, SUITE 101, MIDLOTHIAN, VA 23114
(804) 320-3999
(804) 323-9383
Mailing address
13911 ST FRANCIS BLVD, SUITE 101, MIDLOTHIAN, VA 23114
(804) 320-3999
(804) 323-9383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101054534
VA
207Q00000X
Family Medicine Physician
Primary
0101054534
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005634482
—
VA
05
—
005634491
—
VA
05
—
005643058
—
VA
01
—
080130560
RAILROAD MEDICARE
VA
01
—
272290
ANTHEM BC
VA
05
—
5631149
—
VA
Enumeration date
10/31/2005
Last updated
05/15/2008
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