MEDICARE: SHAUKAT JAHAN MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101046985	VA

General Provider Information

NPI Number	:	1255492229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAUKAT JAHAN MD PC

Provider Business Mailing Address
First Line	:	21495 RIDGETOP CIR STE 203
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20166-6512
Country	:	US
Telephone Number	:	703-421-4050
Fax Number	:

Provider Business Practice Location Address
First Line	:	21495 RIDGETOP CIR STE 203
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20166-6512
Country	:	US
Telephone Number	:	703-421-4050
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAUKAT JAHAN
Credential	:
Telephone Number	:	703-421-4050

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/22/2020

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