| Paul V Detrisac Md Pc | |
|
24 N Saint Joseph Ave Niles MI 49120-2263 | |
| (269) 684-8356 | |
| Not Available |
| Full Name | Paul V Detrisac Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 24 N Saint Joseph Ave, Niles, Michigan |
| Authorized Official Name and Position | Paul V Detrisac (PRESIDENT) |
| Authorized Official Contact | 2696848356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul V Detrisac Md Pc Po Box 998 Niles MI 49120-0998 Ph: () - | Paul V Detrisac Md Pc 24 N Saint Joseph Ave Niles MI 49120-2263 Ph: (269) 684-8356 |
| NPI Number | 1629277439 |
|---|---|
| Provider Enumeration Date | 07/12/2007 |
| Last Update Date | 07/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629277439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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