Organization
Q STREET INTERNISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAGHA SIRMEVAN DISSANAYAKA MD (OWNER)
(541) 726-4110
Entity
Organization
Contact information
Practice address
1180 PATTERSON ST, 3-B, EUGENE, OR 97401-3619
(541) 726-4110
(541) 726-4929
Mailing address
1180 PATTERSON ST, 3-B, EUGENE, OR 97401-3619
(541) 726-4110
(541) 726-4929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD21258
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287570
—
OR
Enumeration date
06/11/2007
Last updated
05/18/2010
Update your record
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