Healthcare Provider Details

I. General information

NPI: 1366005183
Provider Name (Legal Business Name): ARMAN C. MOSHYEDI, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8405 GREENSBORO DR STE 120
MC LEAN VA
22102-5106
US

IV. Provider business mailing address

PO BOX 950592
SAINT LOUIS MO
63195-0592
US

V. Phone/Fax

Practice location:
  • Phone: 855-940-4867
  • Fax: 855-721-4867
Mailing address:
  • Phone: 855-711-4867
  • Fax: 641-800-3145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA WILLET
Title or Position: DIRECTOR OF MANAGED CARE
Credential:
Phone: 855-711-4867