David C Pakula, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

M4761 Issued in ID

Practice address

222 Southway
Suite B
Lewiston, ID 83501-2703

Phone

(208) 746-3500

Fax

(208) 746-6423

NPI assigned

Feb 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609842723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SOUTHWAY",
            "address_2": "SUITE B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012703",
            "telephone_number": "208-746-3500",
            "fax_number": "208-746-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SOUTHWAY",
            "address_2": "SUITE B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012703",
            "telephone_number": "208-746-3500",
            "fax_number": "208-746-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKULA",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M4761",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "14070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016252",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Urology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.