Provider Demographics
NPI:1346374618
Name:D'SA, HELEN MARIA (DO,)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:MARIA
Last Name:D'SA
Suffix:
Gender:F
Credentials:DO,
Other - Prefix:DR
Other - First Name:HELEN
Other - Middle Name:MARIA
Other - Last Name:D'SA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:44056 MOUND RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1357
Mailing Address - Country:US
Mailing Address - Phone:586-215-0127
Mailing Address - Fax:
Practice Address - Street 1:44056 MOUND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1357
Practice Address - Country:US
Practice Address - Phone:586-314-1400
Practice Address - Fax:586-314-1406
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014895207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP31190028Medicare PIN
MIP31170028Medicare PIN