Individual
DR. KANTHI WICKRAMARATNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6350 STEVENS FOREST ROAD, SUITE 102, COLUMBIA, MD 21046
(443) 259-3770
(443) 259-3777
Mailing address
3100 WYMAN PARK DRIVE, SUITE 359A, BALTIMORE, MD 21211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D40369
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071121700
—
MD
Enumeration date
09/26/2006
Last updated
05/09/2013
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