Individual
FARESA Z WERAGODA
Active
Individual
FARESA Z WERAGODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
066682
GA
207RC0000X
Cardiovascular Disease Physician
Primary
066682
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003162066A
—
GA
05
—
003162066B
—
GA
05
—
003162066C
—
GA
Enumeration date
04/23/2009
Last updated
02/26/2021
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