Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 10384 | MN |
NPI | 1114900966 |
---|---|
Provider Name | Eric John Decuir |
First Address | Minneapolis, MN 55407-3723 |
Second Address | Minneapolis, MN 55404-4515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 11/03/2021 |