Individual
DR. RAVINDA SAMARAWEERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4160
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-1230
(701) 234-2045
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
12486
ND
2084N0400X
Neurology Physician
390200000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18289
—
ND
Enumeration date
06/29/2008
Last updated
02/14/2021
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