Individual
DR. MORTEZA S MOUSAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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 22191-3300
(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
01
—
060002093
MEDICARE RAILROAD
VA
Enumeration date
05/11/2006
Last updated
01/15/2010
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