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Individual

DR. DON WALTER KANNANGARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D..

Contact information

Practice address
2750 BRIDLE PATH PL, BETHLEHEM, PA 18017-3804
(610) 778-2154
(610) 317-9449
Mailing address
2750 BRIDLE PATH PL, BETHLEHEM, PA 18017-3804
(610) 778-2154
(610) 317-9449

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD019081E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007985050001
PA
01
25MA06232100
LICENSE
NJ
01
A33402
LICENSE
CA
01
D06692200
CDS REGISTRATION
NJ
01
MD019081E
LICENSE
PA
Enumeration date
09/05/2005
Last updated
03/07/2023
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