Provider Demographics
NPI:1396273215
Name:DE SOUZA, BRIANNA (MD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:DE SOUZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3200 BLUE RIDGE RD STE 118
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8087
Mailing Address - Country:US
Mailing Address - Phone:919-439-1901
Mailing Address - Fax:919-439-1906
Practice Address - Street 1:3200 BLUE RIDGE RD STE 118
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8087
Practice Address - Country:US
Practice Address - Phone:919-439-1901
Practice Address - Fax:919-439-1906
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146005207N00000X
NC2018-02230207N00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology