Provider Demographics
NPI:1609304260
Name:D'SOUZA, ELIZABETH LIU (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LIU
Last Name:D'SOUZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:YUNG HUI
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:859 MOUNT VERNON HWY NE STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4255
Mailing Address - Country:US
Mailing Address - Phone:404-785-0588
Mailing Address - Fax:404-785-0596
Practice Address - Street 1:859 MOUNT VERNON HWY NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4255
Practice Address - Country:US
Practice Address - Phone:404-785-0588
Practice Address - Fax:404-785-0596
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant