Individual
DR. VENKATA SASIDHAR MAJJIGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 N 8TH STREET, SIU SCHOOL OF MEDICINE, PEDIATRICS, ROOM 3A169, SPRINGFIELD, IL 62794
(217) 545-7732
(217) 757-6488
Mailing address
PO BOX 19676, SPRINGFIELD, IL 62794-9676
(800) 331-2229
(217) 757-6488
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036.127301
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036127301
—
IL
Enumeration date
05/13/2011
Last updated
05/25/2011
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