MEDICARE: DR. SHIVAN RAJKUMAR GOSINE M.D.

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	207RG0100X	Gastroenterology Physician	D0038521	MD
2	207RG0100X	Gastroenterology Physician	MD15783	DC

General Provider Information

NPI Number	:	1558415570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIVAN RAJKUMAR GOSINE M.D.

Provider Business Mailing Address
First Line	:	2101 E JEFFERSON ST
Second Line	:	KAISER PERMANENTE MEDICARE ENROLLEMENT
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:	301-816-6308

Provider Business Practice Location Address
First Line	:	700 2ND STREET, NORTH EAST
Second Line	:	CAPITOL HILL MEDICAL CENTER
City	:	WASHINGTON
State	:	DC
Zip	:	20002
Country	:	US
Telephone Number	:	202-346-3000
Fax Number	:

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	11/28/2011

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