Provider Demographics
NPI:1811135940
Name:KELEGAMA, ANANADANEE DILUKSHI (MD)
Entity type:Individual
Prefix:
First Name:ANANADANEE
Middle Name:DILUKSHI
Last Name:KELEGAMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANANADANEE
Other - Middle Name:D
Other - Last Name:RATNAYAKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5450 FRANTZ RD
Mailing Address - Street 2:STE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 E MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5369
Practice Address - Country:US
Practice Address - Phone:614-566-9933
Practice Address - Fax:614-566-8610
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35093193207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2931484Medicaid
OH4263801Medicare PIN