Individual
MRS. ABHIMANI WICKRAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6001 W OUTER DR STE 114, DETROIT, MI 48235-2626
(313) 966-9444
(313) 966-9418
Mailing address
15720 WOODLAND DR, DEARBORN, MI 48120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301508527
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351047311
MI
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
10/28/2020
Last updated
10/18/2023
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