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NPI Code Detail

MEDICARE: HEMACHANDRA PEMASIRI GUNAWARDHANA MD

MEDICARE: HEMACHANDRA PEMASIRI GUNAWARDHANA 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
12084P0800XPsychiatry Physician34011MO
22084P0800XPsychiatry Physician63341GA

General Provider Information

NPI Number : 1558369413
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEMACHANDRA PEMASIRI GUNAWARDHANA MD
Provider Business Mailing Address
First Line : 3188 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-8256
Country : US
Telephone Number : 770-319-6000
Fax Number : 770-319-6330
Provider Business Practice Location Address
First Line : 3188 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-8256
Country : US
Telephone Number : 770-319-6000
Fax Number : 770-319-6330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 02/21/2024

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