Healthcare Provider Details

I. General information

NPI: 1265317788
Provider Name (Legal Business Name): GELA PAMUKOVA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 SURRATTS RD STE 306
CLINTON MD
20735-3362
US

IV. Provider business mailing address

7501 SURRATTS RD STE 306
CLINTON MD
20735-3362
US

V. Phone/Fax

Practice location:
  • Phone: 301-877-5677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberC0010114
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: