# PRIYAN SAMARAKOON PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851694517
- **Authorized official:** PRIYAN SAMARAKOON MD (MEMBER)
- **Authorized official phone:** (910) 534-4434

## Contact information

- **Practice address:** 200 NORTH MAIN STREET, CLIO, SC 29525
- **Practice address phone:** (843) 586-2292
- **Practice address fax:** (843) 306-4622
- **Mailing address:** 11560 FAIRWAY DR, LAURINBURG, NC 28352-7958
- **Mailing address phone:** (910) 534-4434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | NC - 2009-01120 | NC | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | SC - MD 28542 | SC | — |
| 207RP1001X | Pulmonary Disease Physician | NC - 2009-01120 | NC | — |
| 207RP1001X | Pulmonary Disease Physician | SC - MD 28542 | SC | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | NC - 2009-01120 | NC | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | SC - MD 28542 | SC | — |

## Other

- **Enumeration date:** 12/17/2010
- **Last updated:** 12/17/2010