Souza, Sandra L

Souza, Sandra L is an individual health care provider with primary practice located at 2121A Bellevue Rd , Dublin GA 31021-2998. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Souza, Sandra L can be contacted via phone (478) 272-1190.

Contact Information

Primary practice address
2121A Bellevue Rd Dublin GA 31021-2998
Phone: (478) 272-1190
Fax: (478) 274-7628
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 039476 Georgia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 39476 Georgia

Profile Details

NPI number 1043203839
LBN Legal business name Souza, Sandra L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Jan 10th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043203839 NPPES
Georgia MEDICAID 000606284H
Georgia MEDICAID 000666113D
Georgia MEDICAID 300030912A

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