Individual
SAMUEL KOBINA DESOUZA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1500 S DOBSON RD STE 202, MESA, AZ 85202-4724
(866) 974-2673
Mailing address
1500 S DOBSON RD STE 202, MESA, AZ 85202-4724
(866) 974-2673
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/13/2020
Last updated
11/09/2020
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