Organization
DESWIL MEDICAL GROUP PLLC
Active
Other names
Arise Medical and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANA WILMOT-DESOUZA MD (CEO)
(952) 522-6344
Entity
Organization
Contact information
Practice address
15815 FRANKLIN TRL SE STE 501, PRIOR LAKE, MN 55372-2076
(952) 522-6344
Mailing address
15815 FRANKLIN TRL SE STE 501, PRIOR LAKE, MN 55372-2076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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