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Individual

HASITHA IDANGODAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1201 11TH AVE SW, MINOT, ND 58701-4207
(701) 858-6778
(701) 858-6811
Mailing address
1201 11TH AVE SW, MINOT, ND 58701-4207
(701) 858-6778
(701) 858-6811

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.1411045
IL
207Q00000X
Family Medicine Physician
RL12778
ND

Other

Enumeration date
07/02/2013
Last updated
04/14/2026
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