Individual
ROMALDO DESOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6344 TRED AVON PLACE, GAINESVILLE, VA 20155
(703) 217-6255
Mailing address
12032 WINDING CREEK CT, CLIFTON, VA 20124-2242
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0101128303
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006
CAREFIRST BC OF NCA NUMBE
DC
05
—
005824184
—
VA
05
—
017717400
—
DC
01
—
211234
TRIGON BC NUMBER
VA
01
—
53309413
CAREFIRST BC NUMBER
MD
05
—
559930001
—
MD
Enumeration date
02/24/2006
Last updated
05/19/2021
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