Individual
ALEXANDRE DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6844
(304) 927-6807
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6844
(304) 927-6807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18860
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114172000
—
WV
05
—
1922068469
—
WV
Enumeration date
03/24/2006
Last updated
07/23/2012
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