Individual
PRABATH MADUSANKA HERATH MUDIYANSELAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3525 OLENTANGY RIVER RD STE 4330, COLUMBUS, OH 43214-3937
(614) 255-6900
(614) 255-6901
Mailing address
3525 OLENTANGY RIVER RD STE 4330, COLUMBUS, OH 43214-3937
(614) 255-6900
(614) 255-6901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.018702
OH
207R00000X
Internal Medicine Physician
58.030211
OH
208M00000X
Hospitalist Physician
009089
AZ
Other
Enumeration date
07/09/2018
Last updated
07/16/2026
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