Provider Demographics
NPI:1629504899
Name:DSOUZA, NIGEL (MD)
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:
Last Name:DSOUZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:877-373-0871
Mailing Address - Fax:
Practice Address - Street 1:DOGWOOD AVENUE
Practice Address - Street 2:VA BLDG 52
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-439-2225
Practice Address - Fax:423-439-2250
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53152286662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry