Healthcare Provider Details

I. General information

NPI: 1235692021
Provider Name (Legal Business Name): BRIAN SOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS STREET, CWN L1
BOSTON MA
02115
US

IV. Provider business mailing address

BRIGHAM AND WOMEN'S HOSPITAL 75 FRANCIS STREET, CWN L1
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 917-991-9912
  • Fax:
Mailing address:
  • Phone: 617-732-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number291873
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number291873
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number291873
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: