Healthcare Provider Details

I. General information

NPI: 1982976247
Provider Name (Legal Business Name): ISHRAT JAHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 NEIL AVE
COLUMBUS OH
43215-1609
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-228-8888
  • Fax: 614-293-4890
Mailing address:
  • Phone: 614-228-8888
  • Fax: 614-293-4890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35.141143
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: