Provider Demographics
NPI:1124272976
Name:WIMALAWANSA, SUNISHKA M (MD, MBA)
Entity type:Individual
Prefix:
First Name:SUNISHKA
Middle Name:M
Last Name:WIMALAWANSA
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2361 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3695
Mailing Address - Country:US
Mailing Address - Phone:937-704-2130
Mailing Address - Fax:937-704-2140
Practice Address - Street 1:2361 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3695
Practice Address - Country:US
Practice Address - Phone:937-704-2130
Practice Address - Fax:937-704-2140
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0970242086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery