| Mary Louise Decker Md | |
|
107 Loomis St Wilkes Barre PA 18702-4637 | |
| (570) 822-6036 | |
| Not Available |
| Full Name | Mary Louise Decker Md |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 107 Loomis St, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | Mary Louise Decker (OWNER) |
| Authorized Official Contact | 5708226036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Louise Decker Md 107 Loomis St Wilkes Barre PA 18702-4637 Ph: (570) 822-6036 | Mary Louise Decker Md 107 Loomis St Wilkes Barre PA 18702-4637 Ph: (570) 822-6036 |
| NPI Number | 1366593121 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366593121 | NPI | - | NPPES |
| 1017052180001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | MD065216L (Pennsylvania) | Primary |
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