Individual provider · Type 1 NPI

Dane Wanniarachige, MD

Student in an Organized Health Care Education/Training Program · Bangor, ME

NPI number 1023636503 Active

Practice location

895 Union St Ste 12
Bangor, ME 04401-3054

Call (207) 973-7979 Map

Fax (207) 947-9579

Mailing address

43 Whiting Hill Rd Ste 350
Brewer, ME 04412-1020

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1023636503

Dane Wanniarachige, MD's National Provider Identifier is 1023636503, issued on Jul 10, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bangor, ME. The record was last updated on Jul 10, 2020.