Individual
MR. DAVID DENNIS DERECZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1557
Mailing address
30746 COUNTRY RIDGE CIR, FARMINGTON HILLS, MI 48331-1107
(248) 788-0209
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001252
MI
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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