| Dr Heather Anne Decker, MD | |
|
2251 Connecticut Ave S, Sartell, MN 56377 | |
| (320) 253-5220 | |
| (320) 203-2200 |
| Full Name | Dr Heather Anne Decker |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 2251 Connecticut Ave S, Sartell, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336114529 | NPI | - | NPPES |
| 036111062 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036111062 (Illinois) | Secondary |
| 208000000X | Pediatrics | 63914 (Minnesota) | Primary |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Entity Name | Group Health Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Heather Anne Decker, MD 8170 33rd Ave S, Ms 21110q, Bloomington, MN 55425-4516 Ph: (320) 253-5220 | Dr Heather Anne Decker, MD 2251 Connecticut Ave S, Sartell, MN 56377 Ph: (320) 253-5220 |
Emily Korman, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 111 2nd St S, Sartell, MN 56377 Phone: 320-281-3339 Fax: 320-200-7505 | |
David Smith, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 111 2nd St S, Sartell, MN 56377 Phone: 320-281-3339 Fax: 320-251-6942 |