Fonseka, Kumudinie C
Fonseka, Kumudinie C is an individual health care provider with primary practice located at 21327 Harper Avenue Suite D, St Clair Shores MI 48080. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Fonseka, Kumudinie C can be contacted via phone (586) 772-2300.Contact Information
Primary practice address
21327 Harper Avenue Suite D
St Clair Shores MI 48080
Phone: (586) 772-2300
Fax: (586) 772-7111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301049484 | Michigan |
Profile Details
| NPI number | 1376653089 |
|---|---|
| LBN Legal business name | Fonseka, Kumudinie C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Oct 22nd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376653089 | NPPES |
| Michigan | MEDICAID | 1943271 |
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