Individual
MEDHINE ANUSHA WIJETILLEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
163 FORT EVANS RD NE, LEESBURG, VA 20176
(703) 443-2000
Mailing address
6287 DUNAWAY CT, MC LEAN, VA 22101-2205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101244075
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659548873
—
VA
Enumeration date
05/15/2008
Last updated
12/08/2018
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