Provider Demographics
NPI:1780326421
Name:TINKA HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TINKA HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SELIAT
Authorized Official - Middle Name:AJOKE
Authorized Official - Last Name:DOSUNMU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:571-349-8285
Mailing Address - Street 1:4380B MONTGOMERY RD # 1201
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6006
Mailing Address - Country:US
Mailing Address - Phone:443-295-6600
Mailing Address - Fax:951-281-2991
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3296
Practice Address - Country:US
Practice Address - Phone:443-295-6600
Practice Address - Fax:951-281-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1023483484Medicaid