Paul V Detrisac, MD

Individual provider Critical Care Medicine (Internal Medicine) Physician · NPI 1962506527

Paul V Detrisac, MD is a Critical Care Medicine (Internal Medicine) Physician in Niles, Michigan. Licensed in Indiana and Michigan. Registered with an NPI since 2006.

Licensed in: IN, MI
In the registry since: 2006
Specialties on file: 2

What do these letters mean?

MD — Doctor of Medicine: A physician who completed allopathic medical school.

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Practice location Address checks out

24 N St Joseph Ave
Niles, MI 49120
Phone: (269) 684-8356

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Medicine (Internal Medicine) Physician (primary)	Taxonomy 207RC0200X · Licence PD043661 (MI)
Critical Care Medicine (Internal Medicine) Physician	Taxonomy 207RC0200X · Licence 01032411A (IN)

Record details

NPI number	1962506527
Entity type	Individual (Type 1)
Gender	Male
Credentials	MD
Sole proprietor	No
NPI enumerated	September 12, 2006
Last updated in NPPES	July 10, 2007
Mailing address	Po Box 998, Niles, MI 49120