Provider Demographics
NPI:1275155202
Name:WASSERSTROM, BRIANA ERIN (DO)
Entity type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:ERIN
Last Name:WASSERSTROM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10221 CLAYBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1438
Mailing Address - Country:US
Mailing Address - Phone:954-319-0033
Mailing Address - Fax:
Practice Address - Street 1:315 MEDICAL PARK DR STE 202
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2973
Practice Address - Country:US
Practice Address - Phone:704-863-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO013542084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology