Individual
UPEKSHA SEWWANDI THILAKAWARDANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4017
(410) 535-4000
Mailing address
9852 FAIRFAX SQ APT 230, FAIRFAX, VA 22031-4252
(703) 539-9618
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AC002395
MD
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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