Individual
HIMALI SHESHTRA WIJESOORIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 COURT STREET, WEST BRANCH, MI 48661-0001
(989) 345-8120
(989) 345-8129
Mailing address
640 COURT STREET, WEST BRANCH, MI 48661-0001
(989) 345-8120
(989) 345-8129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA10206300
NJ
207Q00000X
Family Medicine Physician
Primary
4301102341
MI
Other
Enumeration date
08/05/2009
Last updated
12/05/2018
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