Decker, Jill Susanne

Decker, Jill Susanne is an individual health care provider with primary practice located at 345 N Division Rd Suite D, Petoskey MI 49770-9416. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Decker, Jill Susanne can be contacted via phone (231) 347-8382.

Contact Information

Primary practice address
345 N Division Rd Suite D Petoskey MI 49770-9416
Phone: (231) 347-8382
Fax: (231) 347-6628
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 4301080589 Michigan

Profile Details

NPI number 1922106301
LBN Legal business name Decker, Jill Susanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Oct 12th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922106301 NPPES
Michigan MEDICAID 4440294

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