Individual
MR. DEVMITH CHINTHAKA GAJADEERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 AUBREYS LOOP, SOUTH BOSTON, VA 24592-5054
(434) 517-3879
(434) 517-3989
Mailing address
101 AUBREYS LOOP, SOUTH BOSTON, VA 24592-5054
(434) 517-3879
(434) 517-3989
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101265951
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2016
Last updated
10/14/2020
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