Individual
DR. JOSE U DESOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5141 OAKMAN BLVD, DEARBORN, MI 48126-3714
(313) 846-8840
(313) 846-1540
Mailing address
5141 OAKMAN BLVD, DEARBORN, MI 48126-3714
(313) 846-8840
(313) 846-1540
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301031739
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529922
—
MI
01
—
382468447
TAX ID
MI
Enumeration date
09/20/2005
Last updated
03/21/2012
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