Organization
DIABETES AND INTERNAL MEDICINE
Active
Organization
DIABETES AND INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERWIN D'SOUZA MD (PRESIDENT)
(208) 236-1600
Entity
Organization
Contact information
Practice address
2302 E. TERRY STREET, POCATELLO, ID 83201
(208) 236-1600
Mailing address
PO BOX 335, POCATELLO, ID 83204-0335
(208) 236-1600
(208) 236-6695
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
ID
Other
Enumeration date
04/24/2007
Last updated
02/17/2010
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