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General NPI Number Information
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NPI Number | 1265014427
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Entity Type | Individual
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Provider Name | DANIEL SAHAN JAYASURIYA MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1249 15TH STREET SUITE 2000
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City | HUNTINGTON
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State | WV
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Zip | 25701-3662
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Country | US
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Telephone | 304-691-1000
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Fax | 304-691-1693
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Provider Business Mailing Address
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Address Line | 1448 10TH AVE STE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-733-8728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35443
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License Number State | WV
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