Provider Demographics
NPI:1225062383
Name:MASTERSON, BRIAN JOSEPH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:MASTERSON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:JOSEPH
Other - Last Name:MASTERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3580 JOSEPH SIEWICK DR STE 306
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1764
Mailing Address - Country:US
Mailing Address - Phone:703-391-4520
Mailing Address - Fax:703-391-4521
Practice Address - Street 1:3580 JOSEPH SIEWICK DR STE 306
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1764
Practice Address - Country:US
Practice Address - Phone:703-391-4520
Practice Address - Fax:703-391-4521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29293207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine