Provider Demographics
NPI:1811518673
Name:JAYAWEERA, AVANTHI RASADHARI (MD)
Entity type:Individual
Prefix:
First Name:AVANTHI
Middle Name:RASADHARI
Last Name:JAYAWEERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6119
Mailing Address - Country:US
Mailing Address - Phone:984-974-0210
Mailing Address - Fax:919-966-6126
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6119
Practice Address - Country:US
Practice Address - Phone:984-974-0210
Practice Address - Fax:919-966-6126
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine