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Individual

ROWENA A DESOUZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
57 GERMANTOWN CT, SUITE 204, CORDOVA, TN 38018-7273
(901) 758-7770
(901) 266-6417
Mailing address
PO BOX 1000, DEPT # 457, MEMPHIS, TN 38148-0001
(901) 758-7770
(901) 266-6417

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
202053
LA
208800000X
Urology Physician
Primary
51681
TN
208800000X
Urology Physician
P0719
TX
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
51681
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05856545
MS
05
206032001
AR
01
6026501
BCBS
TN
01
P01453290
RAILROAD MEDICARE
TN
05
Q009152
TN
Enumeration date
07/08/2008
Last updated
07/16/2015
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