# SAI SANJEEVANI MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871361121
- **Authorized official:** DR. GOWDHAMI MOHAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (662) 351-0702

## Contact information

- **Practice address:** 785 OHIO AVE, CLARKSDALE, MS 38614-6217
- **Practice address phone:** (662) 351-0702
- **Mailing address:** 785 OHIO AVE, CLARKSDALE, MS 38614-6217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2023
- **Last updated:** 02/07/2024