Organization
CENTER FOR BRAIN AND NEUROCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAJIRA GUNAWARDANE M.D. (OWNER)
(703) 994-6655
Entity
Organization
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 260, FULTON, MD 20759-2565
(301) 490-3700
Mailing address
7625 MAPLE LAWN BLVD, SUITE 260, FULTON, MD 20759-2565
(301) 490-3700
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
D0047120
MD
2084N0400X
Neurology Physician
Primary
D0047119
MD
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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