Healthcare Provider Details

I. General information

NPI: 1144857285
Provider Name (Legal Business Name): MORGAN ELLIS DECKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16835 KERCHEVAL AVE
GROSSE POINTE PARK MI
48230-1532
US

IV. Provider business mailing address

16835 KERCHEVAL AVE
GROSSE POINTE PARK MI
48230-1532
US

V. Phone/Fax

Practice location:
  • Phone: 313-777-7546
  • Fax:
Mailing address:
  • Phone: 313-777-7546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301513314
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number4301513314
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: