Provider Demographics
NPI:1427037373
Name:DECKER, STEVEN E (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:DECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-6017
Mailing Address - Country:US
Mailing Address - Phone:215-646-9220
Mailing Address - Fax:215-646-0715
Practice Address - Street 1:500 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-6017
Practice Address - Country:US
Practice Address - Phone:215-646-9220
Practice Address - Fax:215-646-0715
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016517E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB37260Medicare UPIN
PA122560E3WMedicare ID - Type Unspecified