M. Hossein Razavi, MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101049080 Issued in VA

Legal business name

M. HOSSEIN RAZAVI, MD PC

Practice address

14904 Jefferson Davis Hwy Ste 103
Suite 103
Woodbridge, VA 22191-3908

Phone

(703) 497-4222

Fax

(703) 492-0164

NPI assigned

Aug 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad Hossein Razavi, M.D.NPI 1639167661

Title

Owner

Phone

(703) 497-4222

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Hossein Razavi, MD

  • Gastroenterology Physician
  • Woodbridge, VA
  • NPI 1639167661
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1598874745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-497-4222",
            "fax_number": "703-492-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY STE 103",
            "address_2": "SUITE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-497-4222",
            "fax_number": "703-492-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. HOSSEIN RAZAVI, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "RAZAVI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "HOSSEIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-497-4222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101049080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006077871",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• M. Bernadette Macdonald, APRN-PMH
• Priscilla Maclomotey
• Kayla C. Macri, D.M.D.
• Tiffany Maddox, SPECIALIST

• Specialist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.