Healthcare Provider Details

I. General information

NPI: 1417476649
Provider Name (Legal Business Name): KARAN JATWANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

3517B W OX RD
FAIRFAX VA
22033-1705
US

V. Phone/Fax

Practice location:
  • Phone: 202-677-6903
  • Fax:
Mailing address:
  • Phone: 734-999-7830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD500002694
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number036180481
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: