Individual
TIKIRI RATNAYAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD INC
Contact information
Practice address
1910 CALUMET AVE, VALPARAISO, IN 46383-2704
(219) 464-3696
(219) 464-8115
Mailing address
1910 CALUMET AVE, VALPARAISO, IN 46383-2704
(219) 464-3696
(219) 464-8115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IN01028333
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084568
BLUE CROSS PIN
IN
01
—
000000085652
BLUE CROSS PIN
IN
Enumeration date
05/18/2006
Last updated
11/20/2018
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