JOHN DECKER


Address: 2799 W Grand Blvd, Detroit, MI 48202-2608
Phone: 3139162600

JOHN DECKER (NPI# 1851815492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851815492
Entity Type Individual
Full Name JOHN DECKER
Credential PA-C
Practice Address 2799 W Grand Blvd
Detroit
MI 48202-2608
Mailing Address 143 Hazelwood St
Detroit
MI 48202-1771
Practice Telephone 3139162600
Enumeration Date 2017-07-26
Last Update Date 2017-07-26
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
5601008295 MI Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 2799 W GRAND BLVD
City DETROIT
State MI
Zip Code 48202-2608

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235132069 Donna Prince Radiology 2799 W Grand Blvd, Detroit, MI 48202-2608 2005-05-24
1790386704 Alexandria L Blevins Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-11-05
1255932430 Amy Katlyn Carion 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-11-04
1871194415 Alexandria Denise Roberts Physical Therapist 2799 W Grand Blvd, Detroit, MI 48202-2689 2020-11-02
1174121420 John Charles Sanno Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2689 2020-10-09
1932706991 Fallon J Awe Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-10-02
1922615145 Chelsea Elizabeth Owen Nurse Anesthetist, Certified Registered 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-10-01
1275130395 Zana Latkovac Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-10-01
1487260030 Jessica Lee Moret Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-09-18
1932713237 Lucas Costa Santos Anesthesiology 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-09-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710584602 Andrea Irene Martin Audiologist 2799 E Grand Blvd, Detroit, MI 48202 2020-10-05
1174132583 Odei Alayyas Student in an Organized Health Care Education/Training Program 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 2020-07-31
1912529801 Aroob Nabil Nimer Sweidan Student in an Organized Health Care Education/Training Program 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 2020-05-13
1306485636 Katie Burlen-davis Registered Nurse 9045 Woodward Ave, Detroit, MI 48202 2020-01-03
1407401250 Santhalakshmi Angappan Student in an Organized Health Care Education/Training Program Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 2019-08-08
1851945687 Walter Mitini Etoh Nurse Practitioner Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 2019-07-30
1467913756 Andrew Michael Schock Emergency Medicine Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 2019-03-28
1700363892 Zaid Al-saheli Student in an Organized Health Care Education/Training Program 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 2018-07-23
1932690096 Yusuf Naser Alalwan Student in an Organized Health Care Education/Training Program 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 2018-05-24
1568952729 Kelvin Sellers Massage Therapist 832 Seward, Detriot, MI 48202 2018-05-14
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831340355 Antonia L Navarro Physician Assistant University Physician Group Oncology, 4100 John R, Detroit, MI 48201-2013 2008-10-02
1104974443 Amy B Oatfield Physician Assistant Henry Ford Hospital Trauma and Critical Care Cfp-1, 2799 West Grand Blvd, Detroit, MI 48202 2007-01-05
1295750677 Ingrid Dominic Mitchell Physician Assistant 18254 Livernois Ave Ste 1, Detroit, MI 48221-4214 2006-07-13
1952397291 Kelly Michelle Brown Physician Assistant 22151 Moross Rd Ste 320, Maternal Fetal Medicine St John Hospital & Medical Cen, Detroit, MI 48236-2196 2005-09-22
1467067975 Jerrica Clemens Physician Assistant 4100 Woodward Ave, Detroit, MI 48201-2173 2020-09-11
1679195176 Shane Michael Dignan Physician Assistant 259 Mack Ave, Detroit, MI 48201-2427 2020-05-07
1174154843 Weston Alexander Davis Physician Assistant 22101 Moross Rd, Detroit, MI 48236-2148 2020-01-30
1689225443 Alaa Eddin Tahboub Physician Assistant 4771 Michigan Ave, Detroit, MI 48210-9718 2019-09-24
1609338367 Aanchal Bhojwani Physician Assistant 2799 W Grand Blvd, Detroit, MI 48202-2608 2019-04-02
1952883068 Jeremy Lynn Herzberg Physician Assistant 2799 W Grand Blvd, Detroit, MI 48202-2608 2018-09-05
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Competitor

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City DETROIT
Zip Code 48202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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