Individual
GAYANI RASHMIKA FONSEKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(586) 498-4422
(586) 498-4440
Mailing address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(586) 498-4422
(586) 498-4440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301109479
MI
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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