Healthcare Provider Details

I. General information

NPI: 1457903254
Provider Name (Legal Business Name): DHWANI SANJAY SAHJWANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/14/2023
Certification Date: 07/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW 3.5 WEST WING
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-576-5000
  • Fax: 202-476-4741
Mailing address:
  • Phone: 202-476-5694
  • Fax: 202-476-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101275135
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberMD210011944
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: