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Individual
DR. AMILA VIMARA NISSANKA
Active
Individual
DR. AMILA VIMARA NISSANKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.157093
IL
207Q00000X
Family Medicine Physician
125071582
IL
207Q00000X
Family Medicine Physician
45836
AL
207Q00000X
Family Medicine Physician
63792
AZ
207Q00000X
Family Medicine Physician
74854-20
WI
207Q00000X
Family Medicine Physician
Primary
A174462
CA
208600000X
Surgery Physician
125071582
IL
Other
Enumeration date
10/10/2017
Last updated
05/04/2023
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