Individual
DR. MATTHEW DENSON DESHAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20217
MS
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
55402
TN
207RC0000X
Cardiovascular Disease Physician
20217
MS
207RC0000X
Cardiovascular Disease Physician
55402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00277253
—
MS
01
—
20217
STATE LICENSE
MS
05
—
Q026400
—
TN
Enumeration date
05/24/2007
Last updated
07/09/2018
Update your record
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