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General NPI Number Information
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NPI Number | 1275028276
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Entity Type | Individual
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Provider Name | DILEEPA CHATHURANGA RAMANAYAKE PATHIRANNEHELAGE MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 1015 S HACKETT RD
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City | WATERLOO
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State | IA
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Zip | 50701-3543
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Country | US
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Telephone | 319-234-5990
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Fax | 319-234-5994
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Provider Business Mailing Address
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Address Line | PO BOX 2758
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City | WATERLOO
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State | IA
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Zip | 50704-2758
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Country | US
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Telephone | 319-235-5390
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD-52100
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License Number State | IA
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