Individual
RAJENDRA N. SAJJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7119 NOTTAWAY DR, TYLER, TX 75703-5883
(740) 645-2833
Mailing address
7119 NOTTAWAY DR, TYLER, TX 75703-5883
(740) 645-2833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-08-3487
OH
208M00000X
Hospitalist Physician
Primary
P1402
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185269
UNISON MEDICAID #
OH
01
—
000000322021
ANTHEM BCBS
—
01
—
001714151
MOUNTAIN STATE BCBS
—
01
—
1699722280
NPI
—
05
—
2006784000
—
WV
05
—
2500225
—
OH
01
—
P00074055
RR MEDICARE
OH
Enumeration date
05/28/2006
Last updated
11/21/2016
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