Individual
MADUSHANI WIJETUNGE BELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 WILFORD HALL LOOP, LACKLAND AFB, TX 78236-5638
(210) 916-9928
Mailing address
673 MDG, 5955 ZEAMER AVE, JBER, AK 99506
(907) 551-2992
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
34139
NE
208000000X
Pediatrics Physician
34139
NE
Other
Enumeration date
03/19/2020
Last updated
08/15/2023
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