Derek G. Desouza MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301042922 Issued in MI

Legal business name

DEREK G. DESOUZA MD PLLC

Practice address

36975 Five Mile Rd
Livonia, MI 48154-1871

Phone

(734) 464-0600

NPI assigned

Nov 19, 2017

Last updated

Nov 19, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Irene Martin

Title

Biller

Phone

(734) 674-2739

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511049600000",
    "number": "1659885226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18576 SHADYSIDE ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523246",
            "telephone_number": "734-674-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36975 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541871",
            "telephone_number": "734-464-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK G. DESOUZA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-19",
        "last_updated": "2017-11-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "734-674-2739",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301042922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.