MEDICARE: DR. GAYANI YAHAMPATH DASANAYAKA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	200101539	NC
2	207R00000X	Internal Medicine Physician	200101539	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225011539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAYANI YAHAMPATH DASANAYAKA MD

Provider Business Mailing Address
First Line	:	100 KIMEL FOREST DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6074
Country	:	US
Telephone Number	:	336-716-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1814 WESTCHESTER DR STE 301
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-7369
Country	:	US
Telephone Number	:	336-802-2025
Fax Number	:	336-802-2026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/15/2024

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Directions to “ DR. GAYANI YAHAMPATH DASANAYAKA MD” Practice Location

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