Individual
BENJAMIN L MOOSAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3075 US ROUTE 60 STE E540, HUNTINGTON, WV 25705-8859
(304) 528-4600
Mailing address
3075 US ROUTE 60, HUNTINGTON, WV 25705-8859
(304) 528-4600
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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