Provider Demographics
NPI:1699720102
Name:DEGALA, AJITA V (MD)
Entity type:Individual
Prefix:DR
First Name:AJITA
Middle Name:V
Last Name:DEGALA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3748 SWALLOWTAIL TRACE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-7011
Mailing Address - Country:US
Mailing Address - Phone:850-893-9683
Mailing Address - Fax:850-893-9683
Practice Address - Street 1:3748 SWALLOWTAIL TRACE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-7011
Practice Address - Country:US
Practice Address - Phone:850-893-9683
Practice Address - Fax:850-893-9683
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 497812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry