Individual
MICHAEL DECANDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K3152
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0004
MEDICARE RAILROAD GRP
TX
01
—
P00141786
MEDICARE RAILROAD INDV
TX
Enumeration date
08/30/2006
Last updated
11/02/2007
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