Provider Demographics
NPI:1720068240
Name:DECKER, HEIDI CATON (MD)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:CATON
Last Name:DECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:ANN
Other - Last Name:CATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:21 MAIN ST
Mailing Address - Street 2:FRANKLIN HEALTH LIVERMORE FALLS FAMILY PRACTICE
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1219
Mailing Address - Country:US
Mailing Address - Phone:207-897-6601
Mailing Address - Fax:207-897-4339
Practice Address - Street 1:21 MAIN ST
Practice Address - Street 2:FRANKLIN HEALTH LIVERMORE FALLS FAMILY PRACTICE
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1219
Practice Address - Country:US
Practice Address - Phone:207-897-6601
Practice Address - Fax:207-897-4339
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME15275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME264600099Medicaid
ME080162243OtherRAILROAD MEDICARE
ME080162243Medicare PIN
H17236Medicare UPIN
ME264600099Medicaid