Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301119201 | MI |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 4301119201 | MI |
NPI | 1023350493 |
---|---|
Provider Name | Dr. Robert G. Dekker |
First Address | Rochester, MI 48307-1871 |
Second Address | Rochester, MI 48307-1871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 20/01/2020 |