Provider Demographics
NPI:1124439740
Name:PAKALA, TINA (MD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:PAKALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-3125
Mailing Address - Fax:717-334-3184
Practice Address - Street 1:37 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2004
Practice Address - Country:US
Practice Address - Phone:717-339-3125
Practice Address - Fax:717-334-3184
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-02567207RG0100X
PAMD479034207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology