Individual
DR. SAMANTHA SHARMINI DEWUNDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
241 CORPORATE BLVD, SUITE 210, NORFOLK, VA 23502-4975
(757) 622-2200
(757) 965-9493
Mailing address
241 CORPORATE BLVD, SUITE 210, NORFOLK, VA 23502-4975
(757) 622-2200
(757) 965-9493
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101258106
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10152490
OPTIMA
VA
01
—
1659689693
HUMANA
VA
05
—
1659689693
—
NC
05
—
1659689693
—
VA
01
—
547397
ANTHEM BCBS
VA
01
—
P01548824
RR MEDICARE
VA
Enumeration date
09/23/2010
Last updated
01/08/2016
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