Provider Demographics
NPI:1255528774
Name:ALPANA GOSWAMI MD PA
Entity type:Organization
Organization Name:ALPANA GOSWAMI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALPANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-984-3100
Mailing Address - Street 1:10622 ALLOWAY DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1600
Mailing Address - Country:US
Mailing Address - Phone:301-984-3100
Mailing Address - Fax:301-984-3130
Practice Address - Street 1:11125 ROCKVILLE PIKE
Practice Address - Street 2:SUITE #110
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-984-3100
Practice Address - Fax:301-984-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01063Medicare PIN