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General NPI Number Information
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NPI Number | 1578718821
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Entity Type | Individual
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Provider Name | DMITRI SOUZA M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2008
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Last Update Date | 06/23/2017
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Provider Practice Location Address
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Address Line | 1900 23RD ST
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44223-1404
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Country | US
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Telephone | 330-971-7246
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Fax | 330-971-7256
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Provider Business Mailing Address
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Address Line | 1900 23RD ST
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44223-1404
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Country | US
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Telephone | 330-971-7246
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Fax | 330-971-7256
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35.096297
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.096297
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35.096297
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License Number State | OH
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