MEDICARE: DR. NEHA GAJJAR-SIVA MD

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	207R00000X	Internal Medicine Physician	0101235298	VA
2	208000000X	Pediatrics Physician	0101235298	VA
3	208M00000X	Hospitalist Physician	D0071755	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376534172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEHA GAJJAR-SIVA MD

Provider Business Mailing Address
First Line	:	2828 CONNECTICUT AVE NW
Second Line	:	#807
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1536
Country	:	US
Telephone Number	:	202-422-3688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 CONNECTICUT AVE NW
Second Line	:	#807
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1536
Country	:	US
Telephone Number	:	202-422-3688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/20/2013

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