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Individual

SIJI SAJU THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
103278
GA
363L00000X
Nurse Practitioner
Primary
759958
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286682401
TX
01
861N03
BCBS
TX
Enumeration date
11/07/2011
Last updated
02/20/2026
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