Healthcare Provider Details

I. General information

NPI: 1407051840
Provider Name (Legal Business Name): TAHIRA IRUM LODHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2007
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW DIVISION OF GERIATRICS
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2191
  • Fax: 202-741-2791
Mailing address:
  • Phone: 202-741-2191
  • Fax: 202-741-2791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD039090
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD039090
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: