Individual
WANNAKUWATTE W. FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
76254
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3152634
—
MA
Enumeration date
11/23/2005
Last updated
04/21/2025
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