Individual provider · Type 1 NPI
Kanishka Thiran Jayasundera
Retina Specialist (Ophthalmology) Physician · Ann Arbor, MI
NPI number
1992090625
Active
Practice location
1000 Wall Street
Ann Arbor, MI 48105-1912
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology Physician | 207W00000X | 4301093385 (MI) |
| Retina Specialist (Ophthalmology) Physician Primary | 207WX0107X | SFP53 (CA) |
Retina Specialist (Ophthalmology) Physician: An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
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About NPI 1992090625
Kanishka Thiran Jayasundera's National Provider Identifier is 1992090625, issued on Jun 10, 2011. The primary taxonomy on file is Retina Specialist (Ophthalmology) Physician (207WX0107X), and the practice location is in Ann Arbor, MI. The record was last updated on Sep 2, 2025.