MRS. CHANDIMA JINANI HERATH MUDIYANSELAGE (NPI# 1992327969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992327969 |
| Entity Type | Individual |
| Full Name | MRS. CHANDIMA JINANI HERATH MUDIYANSELAGE |
| Credential | M.D. |
| Practice Address |
6071 W Outer Dr Detroit MI 48235 |
| Mailing Address |
4201 St. Antoine Uhc 9c Detroit MI 48201 |
| Practice Telephone | 3139663250 |
| Mailing Telephone | 3137455147 |
| Mailing Fax Number | 3139938501 |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
6071 W OUTER DR |
| City | DETROIT |
| State | MI |
| Zip Code | 48235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836806 | Select Specialty Hospital - Northwest Detroit Inc | Long Term Care Hospital | 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 | 2005-07-26 |
| 1356965198 | Anielle Ball | Registered Nurse | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-07 |
| 1427672708 | Nitesh Kumar Byrappa | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-03 |
| 1790307783 | Patrick Riedy | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-12 |
| 1518589878 | Nnadozie Okoroafor | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-09 |
| 1720609803 | Charmayne Gail Cooley | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1841811890 | Noren Din | Internal Medicine | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1962023069 | Haseeb Khan | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-29 |
| 1285255570 | Edward Park | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-28 |
| 1427679828 | Danielle Murphy | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1629690565 | Faseeha Arshad Gondal | Student in an Organized Health Care Education/Training Program | Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 | 2020-05-14 |
| 1902428832 | Muhanad Abou Touk | Student in an Organized Health Care Education/Training Program | Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 | 2020-05-14 |
| 1780206730 | Ahmad Mismar | Student in an Organized Health Care Education/Training Program | Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 | 2020-05-13 |
| 1023630589 | Joao Paulo Fontana Bragagnollo | Student in an Organized Health Care Education/Training Program | 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 | 2020-05-07 |
| 1881216216 | Mohammad Awad Jaber | Student in an Organized Health Care Education/Training Program | 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 | 2020-05-07 |
| 1366064818 | Syeda Busmah Owais | Student in an Organized Health Care Education/Training Program | 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 | 2020-05-07 |
| 1184245680 | Sushmitha Nanja Reddy | Student in an Organized Health Care Education/Training Program | Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 | 2020-05-06 |
| 1972164796 | Jack Phillip Tomen | Student in an Organized Health Care Education/Training Program | Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 | 2019-06-24 |
| 1346809464 | Anusha Bapatla | Student in an Organized Health Care Education/Training Program | 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 | 2019-06-12 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.