| Jasmine Moghissi, M.d., P.c. | |
|
9401 Lee Hwy Suite 302 Fairfax VA 22031-1849 | |
| (703) 281-5560 | |
| (703) 281-5568 |
| Full Name | Jasmine Moghissi, M.d., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 9401 Lee Hwy, Fairfax, Virginia |
| Authorized Official Name and Position | Jasmine Moghissi (PRESIDENT) |
| Authorized Official Contact | 7032815560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasmine Moghissi, M.d., P.c. 9401 Lee Hwy Suite 302 Fairfax VA 22031-1849 Ph: (703) 281-5560 | Jasmine Moghissi, M.d., P.c. 9401 Lee Hwy Suite 302 Fairfax VA 22031-1849 Ph: (703) 281-5560 |
| NPI Number | 1467644310 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 08/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467644310 | NPI | - | NPPES |
| DF2854 / P00353016 | Other | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101044043 (Virginia) | Primary |
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