Individual
DR. MICHAEL ANDREW DEKORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
713 GOLF VIEW DRIVE, MEDFORD, OR 97504-9643
(541) 770-1225
(541) 770-1245
Mailing address
713 GOLF VIEW DRIVE, MEDFORD, OR 97504-9643
(541) 770-1225
(541) 770-1245
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00247
OR
213ES0131X
Foot Surgery Podiatrist
DP00247
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056981
—
OR
01
—
1297890041
CIGNA (DMERC)
OR
01
—
480029243
RAILROAD MEDICARE
OR
Enumeration date
09/27/2006
Last updated
01/05/2021
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