Provider Demographics
NPI:1710123005
Name:JAHAN, SHAUKAT (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:SHAUKAT
Middle Name:
Last Name:JAHAN
Suffix:
Gender:F
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21495 RIDGETOP CIR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6512
Mailing Address - Country:US
Mailing Address - Phone:703-421-4050
Mailing Address - Fax:703-406-4552
Practice Address - Street 1:21495 RIDGETOP CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6512
Practice Address - Country:US
Practice Address - Phone:703-421-4050
Practice Address - Fax:703-406-4552
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046985207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006209041Medicaid
VA49D0224567OtherCLIA
VA006209041Medicaid