Healthcare Provider Details

I. General information

NPI: 1467595678
Provider Name (Legal Business Name): SUSAN MOVAHEDI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11445 SUNSET HILLS RD
RESTON VA
20190-5276
US

IV. Provider business mailing address

19260 SNIDER HOUSE CT
LANSDOWNE VA
20176-3868
US

V. Phone/Fax

Practice location:
  • Phone: 703-709-1528
  • Fax:
Mailing address:
  • Phone: 703-298-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0202204891
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number0202204891
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: