Provider Demographics
NPI:1730299298
Name:GILOTRA, RAHUL (MD)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:GILOTRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAHUL
Other - Middle Name:
Other - Last Name:GILOTRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12016 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2004
Mailing Address - Country:US
Mailing Address - Phone:301-942-2105
Mailing Address - Fax:301-942-0670
Practice Address - Street 1:12016 GEORGIA AVENUE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2004
Practice Address - Country:US
Practice Address - Phone:301-942-2105
Practice Address - Fax:301-942-0670
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032417207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD548671800Medicaid
GI572972Medicare ID - Type Unspecified
MD548671800Medicaid