PAUL V DETRISAC

NILES, MI
NPI1962506527
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RC0200X Internal Medicine, Critical Care Medicine
(Licence: MI  PD043661)
Additional Taxonomies207RC0200X Internal Medicine, Critical Care Medicine
(Licence: IN  01032411A)
Enumeration Date2006-09-12
Last Update Date2007-07-10
Business Address
-- PAUL V DETRISAC MD
24 N ST JOSEPH AVE
NILES, MI 49120
Phone number: 269-684-8356
Mailing Address
-- PAUL V DETRISAC MD
PO BOX 998
NILES, MI 49120
Phone number: 269-684-8356