Provider Demographics
NPI:1215983499
Name:DECKER, DAVID MARK (PA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARK
Last Name:DECKER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 196105
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99519-6105
Mailing Address - Country:US
Mailing Address - Phone:907-659-7230
Mailing Address - Fax:907-659-7390
Practice Address - Street 1:700 G ST
Practice Address - Street 2:CONOCOPHILLIPS TOWER KUPARUK MEDICAL NSK 31
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501
Practice Address - Country:US
Practice Address - Phone:907-695-7230
Practice Address - Fax:907-695-7390
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2010-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK#780363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical