Provider Demographics
NPI:1629013560
Name:DECK, MICHAEL D F (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D F
Last Name:DECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6725 POST RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1838
Mailing Address - Country:US
Mailing Address - Phone:401-886-4872
Mailing Address - Fax:401-886-6184
Practice Address - Street 1:65 SOCKANOSSET CROSSROADS
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-941-1454
Practice Address - Fax:401-941-1140
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI120042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology