Healthcare Provider Details

I. General information

NPI: 1275028276
Provider Name (Legal Business Name): DILEEPA CHATHURANGA RAMANAYAKE PATHIRANNEHELAGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 JEFFERSON ST
LAUREL MS
39440-4354
US

IV. Provider business mailing address

PO BOX 247
LAUREL MS
39441-0247
US

V. Phone/Fax

Practice location:
  • Phone: 601-649-2863
  • Fax: 601-649-9479
Mailing address:
  • Phone: 601-425-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35612
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: