Organization
MORTEZA S. MOUSAVI, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORTEZA S. MOUSAVI M.D. (OWNER)
(703) 878-0941
Entity
Organization
Contact information
Practice address
2296 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191-3300
(703) 878-0941
(703) 878-0857
Mailing address
2296 OPITZ BLVD., SUITE 340, WOODBRIDGE, VA 22191-3346
(703) 878-0941
(703) 878-0857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101033951
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006033989
—
VA
Enumeration date
02/22/2010
Last updated
04/01/2010
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