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General NPI Number Information
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NPI Number | 1689650285
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Entity Type | Individual
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Provider Name | WILLIAM MICHAEL GOSMAN PA
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Gender | Male
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2401 HAWKINS POINT RD COAST GUARD YARD CLINIC
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City | BALTIMORE
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State | MD
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Zip | 21226-1797
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Country | US
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Telephone | 410-636-3181
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Fax |
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Provider Business Mailing Address
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Address Line | COMMANDANT (CG-1122) 2100 SECOND STREET SW
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City | WASHINGTON
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State | DC
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Zip | 20593-0001
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Country | US
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Telephone | 410-636-3181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0000545
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License Number State | MD
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