Physician Compare National (NPI:1437148657)

HEALTHCARE PROVIDER: OSBORNE D'SOUZA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1437148657
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072402379
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040315000090
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DSOUZA
	Individual professional last name
Provider First Name	OSBORNE
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1198 BUCKHEAD CROSSING
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	WOODSTOCK
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301894257
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHSIDE HOSPITAL CHEROKEE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y