Provider Demographics
NPI:1821190521
Name:GUNAWARDENA, DIYANA (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DIYANA
Middle Name:
Last Name:GUNAWARDENA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35840 TIMBERLANE DR
Mailing Address - Street 2:MHMC-MEDICINE/CARDIOLOGY
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2429
Mailing Address - Country:US
Mailing Address - Phone:440-840-3875
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:MHMC-MEDICINE/CARDIOLOGY
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-7189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071930207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2119193Medicaid
OHGU269471Medicare ID - Type Unspecified
OH2119193Medicaid