Individual
MEHDI TAVAZOEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1980 GALLOWS RD, TYSONS, VA 22182-3913
(703) 942-5331
Mailing address
1980 GALLOWS RD, TYSONS, VA 22182-3913
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005970
VA
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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