OrganizationActive
Paul V Detrisac MD PC
NPI 1629277439 · Internal Medicine Physician · Niles, MI
Paul V Detrisac MD PC is a Internal Medicine Physician organization in Niles, MI (NPI 1629277439).
Provider details
- NPI number
- 1629277439
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Paul Detrisac, President(269) 684-8356
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
24 N Saint Joseph Ave
Niles, MI 49120-2263
Phone: (269) 684-8356
Street-level locationGet directions
Mailing address
Po Box 998
Niles, MI 49120-0998
Registry dates
- Enumerated
- 2007-07-12
- Last updated
- 2007-07-12
Frequently asked questions
- What is Paul V Detrisac MD PC's NPI number?
- Paul V Detrisac MD PC's National Provider Identifier (NPI) is 1629277439, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Paul V Detrisac MD PC?
- Paul V Detrisac MD PC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Paul V Detrisac MD PC located?
- Paul V Detrisac MD PC's practice location on file with NPPES is 24 N Saint Joseph Ave, Niles, MI 49120-2263.
- What is Paul V Detrisac MD PC's phone number?
- The practice phone number listed in the NPPES registry for Paul V Detrisac MD PC is (269) 684-8356.
- Who is the authorized official for Paul V Detrisac MD PC?
- The authorized official listed on Paul V Detrisac MD PC's NPPES record is Paul Detrisac, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Paul V Detrisac MD PC's NPI active?
- Yes — Paul V Detrisac MD PC's NPI (1629277439) is active in the NPPES registry as of the last update on 2007-07-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.