Individual
PADMA P WIJETILLEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 S CARLIN SPRINGS RD, SUITE 101, ARLINGTON, VA 22204-1064
(703) 379-0704
(703) 379-7947
Mailing address
611 S CARLIN SPRINGS RD, SUITE 101, ARLINGTON, VA 22204-1064
(703) 379-0704
(703) 379-7947
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101033749
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006716059
—
VA
Enumeration date
07/12/2006
Last updated
07/08/2007
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