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Individual

DR. RANDHI WIJEKULARATNE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 653-6741
(325) 481-2166
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2166

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q5902
TX
208M00000X
Hospitalist Physician
Primary
M15216
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Q5902
LICENSE
TX
Enumeration date
06/07/2012
Last updated
06/30/2025
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