Provider Demographics
NPI:1356380513
Name:DEBRINCAT, PAUL GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GEORGE
Last Name:DEBRINCAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21957 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1447
Mailing Address - Country:US
Mailing Address - Phone:248-894-0763
Mailing Address - Fax:
Practice Address - Street 1:5730 N LILLEY RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3685
Practice Address - Country:US
Practice Address - Phone:218-410-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine