Individual
MRS. CHANDIMA JINANI HERATH MUDIYANSELAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7565 DANNAHER DR, POWELL, TN 37849-4029
(865) 859-8000
Mailing address
4201 ST. ANTOINE, UHC 9C, DETROIT, MI 48201
(313) 745-5147
(313) 993-8501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70459
TN
Other
Enumeration date
05/13/2020
Last updated
11/19/2024
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