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Individual
SHAHRIAR MOOSSAVI
Active
Individual
SHAHRIAR MOOSSAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
200200745
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131PM
BCBS
—
05
—
2004959000
—
WV
05
—
5886881
—
VA
01
—
7407457
AETNA
—
01
—
800195
PARTNERS
—
05
—
89131PM
—
NC
01
—
B7288
MEDCOST
—
05
—
Q0074N
—
SC
Enumeration date
12/08/2005
Last updated
03/22/2013
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