Weragoda, Faresa Z

Weragoda, Faresa Z is an individual health care provider with primary practice located at 4800 Olde Towne Pkwy Ste 420 , Marietta GA 30068-4424. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Weragoda, Faresa Z can be contacted via phone (404) 256-2525.

Contact Information

Primary practice address
4800 Olde Towne Pkwy Ste 420 Marietta GA 30068-4424
Phone: (404) 256-2525
Fax: (404) 845-4720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 066682 Georgia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 066682 Georgia

Profile Details

NPI number 1053555870
LBN Legal business name Weragoda, Faresa Z
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2009
Last updated Feb 26th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053555870 NPPES
Georgia MEDICAID 003162066B
Georgia MEDICAID 003162066C
Georgia MEDICAID 003162066A

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