Provider Demographics
NPI:1710069430
Name:MOUSSAVIAN, PARVANEH A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PARVANEH
Middle Name:A
Last Name:MOUSSAVIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10835 S GLEN RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1841
Mailing Address - Country:US
Mailing Address - Phone:202-782-5767
Mailing Address - Fax:202-782-4719
Practice Address - Street 1:WALTER REED MILITARY MEDICAL
Practice Address - Street 2:8901 WISCONSIN AVENUE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-2113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129991835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology