Healthcare Provider Details

I. General information

NPI: 1265476022
Provider Name (Legal Business Name): SHEILA JAHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 N NASH ST UNIT 309
ARLINGTON VA
22209
US

IV. Provider business mailing address

1881 N NASH ST UNIT 309
ARLINGTON VA
22209-1563
US

V. Phone/Fax

Practice location:
  • Phone: 571-332-5757
  • Fax:
Mailing address:
  • Phone: 571-332-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number0101051081
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: