Individual
NISHANIE GUNAWARDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02004583A
IN
2084P0802X
Addiction Psychiatry Physician
02004583A
IN
Other
Enumeration date
06/27/2010
Last updated
07/30/2015
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