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Individual

SEAN BENEDICT D'SOUZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9192 W UNION HILLS DR, PEORIA, AZ 85382-8208
(602) 374-4101
(602) 441-0522
Mailing address
9192 W UNION HILLS DR, PEORIA, AZ 85382-8208
(602) 374-4101
(602) 441-0522

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
40387
AZ
2086S0129X
Vascular Surgery Physician
49960
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
423119
AZ
Enumeration date
07/03/2007
Last updated
09/12/2014
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