Provider Demographics
NPI:1164561379
Name:GOLLA, DINAKAR (MD)
Entity Type:Individual
Prefix:
First Name:DINAKAR
Middle Name:
Last Name:GOLLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 GAMMA DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2917
Mailing Address - Country:US
Mailing Address - Phone:412-963-6677
Mailing Address - Fax:
Practice Address - Street 1:107 GAMMA DR
Practice Address - Street 2:SUITE 210
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2917
Practice Address - Country:US
Practice Address - Phone:412-963-6677
Practice Address - Fax:412-963-6868
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4245422086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery