Dereczyk, Amy
Dereczyk, Amy is an individual health care provider with primary practice located at 4001 W Mcnichols Rd , Detroit MI 48221-3038. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Dereczyk, Amy can be contacted via phone (313) 993-1797.Contact Information
Primary practice address
4001 W Mcnichols Rd
Detroit MI 48221-3038
Phone: (313) 993-1797
Fax: (313) 993-1271
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 5601003980 | Michigan |
Profile Details
NPI number | 1558349050 |
---|---|
LBN Legal business name | Dereczyk, Amy |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 4th, 2006 |
Last updated | May 10th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1558349050 | NPPES |
Other | 11712511 | CAQH |
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