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MICHAEL DETRISAC
NPI 1053689836
Technician, Other - EEG in Ann Arbor, MI

Active since December 07, 2011
812 AVIS DR, ANN ARBOR, MI 48108(734) 622-3920 Get Directions Write a Review

NPPES record last updated: December 7, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael Detrisac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL DETRISAC (NPI 1053689836) is an individual eeg provider in Ann Arbor, Michigan and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1053689836
Entity TypeIndividualMale
Primary Taxonomy2472E0500X
Provider Legal NameMICHAEL DETRISAC
Location Address812 AVIS DRAnn Arbor, MI 48108-9649
Mailing AddressPo Box 104Niles, MI 49120-0104
Phone(734) 622-3920
Sole ProprietorYes
Enumeration DateDecember 7, 2011
✔ NPI 1053689836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician, Other · EEGTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code2472E0500X
812 AVIS DR, Ann Arbor, MI 48108
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEUROMED, INC.
Specialist/Technologist, Other (Electroneurodiagnostic)
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (800) 638-7564
JUSTIN TSAY
Specialist/Technologist, Other (Electroneurodiagnostic)
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (800) 994-8457
NEURALWATCH INDIANA LLC
Specialist
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (734) 213-3920
NEURAL WATCH LLC
Specialist
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (734) 213-3931
NEURALWATCH TEXAS PLLC
Specialist
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (800) 638-7564
JOHN DAVID SODERSTROM CNIM
Specialist/Technologist, Other (Electroneurodiagnostic)
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (734) 717-2983
KEVIN HUDDLESTON
Specialist/Technologist, Other (Electroneurodiagnostic)
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (734) 213-3931
RICHARD HOBAN
Specialist/Technologist, Other (Electroneurodiagnostic)
812 AVIS DR
ANN ARBOR, MI 48108
Washtenaw County (734) 213-3931

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Detrisac's NPI number?

The NPI number for Michael Detrisac is 1053689836. It was assigned to this individual provider in the NPPES registry on December 7, 2011.

Where is Michael Detrisac located?

Michael Detrisac practices at 812 Avis Dr, Ann Arbor, MI 48108. The listed phone number is (734) 622-3920.

What is Michael Detrisac's specialty?

The primary specialty registered for this NPI is Technician, Other, specializing in EEG, with taxonomy code 2472E0500X.

When was this NPI record last updated?

The NPPES record for Michael Detrisac was last updated on December 7, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.