Individual
SOHAIL MOUSSAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12604 LAKE RIDGE DR, WOODBRIDGE, VA 22192-2335
(703) 497-4700
Mailing address
12604 LAKE RIDGE DR, WOODBRIDGE, VA 22192-2335
(703) 497-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101235118
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10018706
—
VA
Enumeration date
10/12/2006
Last updated
07/08/2007
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