Provider Demographics
NPI:1225011539
Name:DASANAYAKA, GAYANI YAHAMPATH (MD)
Entity type:Individual
Prefix:DR
First Name:GAYANI
Middle Name:YAHAMPATH
Last Name:DASANAYAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:
Practice Address - Street 1:1814 WESTCHESTER DR STE 301
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7369
Practice Address - Country:US
Practice Address - Phone:336-802-2025
Practice Address - Fax:336-802-2026
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101539207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135NEMedicaid
NC89135NEMedicaid
NCH58384Medicare UPIN