Organization
ROHINI WIJETILLEKE MD PC
Active
Other names
Family Practice And Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROHINI WIJETILLEKE MD (MD PC)
(703) 471-7733
Entity
Organization
Contact information
Practice address
100 ELDEN STREET, SUITE 14, HERNDON, VA 20170
(703) 471-7733
(703) 471-7733
Mailing address
100 ELDEN STREET, SUITE 14, HERNDON, VA 20170
(703) 471-7733
(703) 471-7733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35528
VA
208000000X
Pediatrics Physician
Primary
35528
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210923
BLUE CROSS BS
—
01
—
281178
AMERIGROUP
—
05
—
5618410
—
VA
05
—
6711324
—
VA
Enumeration date
07/31/2006
Last updated
11/29/2007
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