Organization
ST. JUDE'S INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSBORNE F D'SOUZA MD (PROVIDER)
(678) 324-7406
Entity
Organization
Contact information
Practice address
1198 BUCKHEAD XING, STE C, WOODSTOCK, GA 30189-4257
(678) 324-7406
(770) 627-4322
Mailing address
1198 BUCKHEAD XING, STE C, WOODSTOCK, GA 30189-4257
(678) 324-7406
(770) 627-4322
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
05/08/2014
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