Provider Demographics
NPI:1912124983
Name:MOSTOFI, NAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:MOSTOFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11922
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-9122
Mailing Address - Country:US
Mailing Address - Phone:703-652-0948
Mailing Address - Fax:703-542-3584
Practice Address - Street 1:380 MAPLE AVENUE WEST
Practice Address - Street 2:SUITE# 206
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5620
Practice Address - Country:US
Practice Address - Phone:703-652-0948
Practice Address - Fax:703-542-3584
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00656702084N0400X
VA01012486832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0501704OtherEVERCARE
MD3167780OtherMAMSI MDIPA OCI
MD89774901OtherBCBS
DC0007OtherBCBS
4900003OtherCIGNA
P00443882OtherRAILROAD MEDICARE
7676965OtherAETNA
DC0007OtherBCBS
P00443882OtherRAILROAD MEDICARE
DCM62647Medicare UPIN
MDQ695Medicare PIN
DC022590C53Medicare PIN