Provider Demographics
NPI:1134973258
Name:TUMMALA, DURGANJALI (MBBS)
Entity type:Individual
Prefix:
First Name:DURGANJALI
Middle Name:
Last Name:TUMMALA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUMMIT PACIFIC MEDICAL CENTER 600 E. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98561
Mailing Address - Country:US
Mailing Address - Phone:360-346-2239
Mailing Address - Fax:
Practice Address - Street 1:SUMMIT PACIFIC MEDICAL CENTER 600 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98561
Practice Address - Country:US
Practice Address - Phone:360-346-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program