Provider Demographics
NPI:1710264296
Name:GUNAWARDHANA, CHARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHARA
Middle Name:
Last Name:GUNAWARDHANA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 TIOGA PKWY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7987
Mailing Address - Country:US
Mailing Address - Phone:410-369-1008
Mailing Address - Fax:
Practice Address - Street 1:3201 TIOGA PKWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7987
Practice Address - Country:US
Practice Address - Phone:410-369-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist