Wijetunga, Mevan Nandaka
Wijetunga, Mevan Nandaka is an individual health care provider with primary practice located at 1300 S Columbia Rd , Grand Forks ND 58201. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Wijetunga, Mevan Nandaka can be contacted via phone (701) 780-6236.Contact Information
Primary practice address
1300 S Columbia Rd
Grand Forks ND 58201
Phone: (701) 780-6236
Fax: (701) 780-6221
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 48798 | Minnesota |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 48798 | Minnesota |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MDE33460 | District of Columbia |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 11101 | North Dakota |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 48798 | Minnesota |
Profile Details
| NPI number | 1457308645 |
|---|---|
| LBN Legal business name | Wijetunga, Mevan Nandaka |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Dec 22nd, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457308645 | NPPES |
| Virginia | MEDICAID | 15880581 | |
| Virginia | MEDICAID | 034425200 | |
| Virginia | MEDICAID | 967611200 | |
| Virginia | MEDICAID | 400766200 |
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