Individual
ACHALA SHIVANTHI GUNASENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7211 BANK CT, FREDERICK, MD 21703-8483
(240) 215-6310
(240) 566-7754
Mailing address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 215-6310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0006440
MD
Other
Enumeration date
05/18/2017
Last updated
08/27/2024
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