Luke Deckert

Individual provider Active NPI Independent Duty Corpsman · Southwest Harbor, ME

NPI 1770274151 · NPPES record last updated May 17, 2023

Key facts

NPI
1770274151
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
184 Clark Point Rd
Southwest Harbor, ME 04679-4414
Phone
(207) 244-4678
Fax
(207) 244-4613
NPI assigned
May 17, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
E3270814MEMDBasic Emergency Medical Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E3270814 ME
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

184 Clark Point Rd
Southwest Harbor, ME 04679-4414

Mailing address

184 Clark Point Rd
Southwest Harbor, ME 04679-4414
Phone (207) 244-4678

Other providers in Southwest Harbor, ME

All providers in Southwest Harbor, ME · Independent Duty Corpsman in Maine

Sources for this page

Verify at the official NPI Registry.