Individual
KANISHKA GUNADASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 N CHURCH ST, GREENSBORO, NC 27401-1007
(336) 832-8468
Mailing address
1125 N CHURCH ST, GREENSBORO, NC 27401-1007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217701
NC
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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