MEDICARE: SAHIRA LONG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD34067	DC

General Provider Information

NPI Number	:	1558334722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAHIRA LONG M.D.

Provider Business Mailing Address
First Line	:	2101 MARTIN LUTHER KING JR AVE SE FL 5
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5702
Country	:	US
Telephone Number	:	202-476-6900
Fax Number	:	202-476-7613

Provider Business Practice Location Address
First Line	:	2101 MARTIN LUTHER KING JR AVE SE FL 5
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5702
Country	:	US
Telephone Number	:	202-476-6900
Fax Number	:	202-476-7613

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	08/29/2022

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