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1720158223
DAVID DENNIS DERECZYK
DETROIT, MI
NPI
1720158223
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MI 001252)
Enumeration Date
2006-11-09
Last Update Date
2007-07-08
Business Address
Mr. DAVID DENNIS DERECZYK PA-C
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number: 313-916-1557
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Mailing Address
Mr. DAVID DENNIS DERECZYK PA-C
30746 COUNTRY RIDGE CIR
FARMINGTON HILLS, MI 48331-1107
Phone number: 248-788-0209
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