Individual provider · Type 1 NPI

David Dennis Dereczyk, PA-C

Medical Physician Assistant · Detroit, MI

NPI number 1720158223 Active

Practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Call (313) 916-1557 Map

Mailing address

30746 Country Ridge Cir
Farmington Hills, MI 48331-1107

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X001252 (MI)

Medical Physician Assistant: Definition to come...

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About NPI 1720158223

David Dennis Dereczyk, PA-C's National Provider Identifier is 1720158223, issued on Nov 9, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.