Individual
DR. NISAL K SAMARASEKERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6320 W UNION HILLS DR STE A210, GLENDALE, AZ 85308-7212
(623) 362-8866
(623) 362-8867
Mailing address
6320 W UNION HILLS DR STE A210, GLENDALE, AZ 85308-7212
(623) 362-8866
(623) 362-8867
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23001
AZ
Other
Enumeration date
05/01/2006
Last updated
12/10/2009
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