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Individual
BENJAMIN L MOOSAVI
Active
Individual
BENJAMIN L MOOSAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
64608
GA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
22625
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376460880B
—
GA
Enumeration date
05/09/2007
Last updated
04/23/2025
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