Individual
AJITH HERATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13620 CRAYTON BLVD, HAGERSTOWN, MD 21742-2335
(240) 313-3100
(240) 313-3101
Mailing address
13620 CRAYTON BLVD, HAGERSTOWN, MD 21742-2335
(240) 313-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005384
MD
Other
Enumeration date
05/14/2014
Last updated
05/28/2019
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