Provider Demographics
NPI:1003804204
Name:EAPEN, SAJI (MD)
Entity Type:Individual
Prefix:
First Name:SAJI
Middle Name:
Last Name:EAPEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAJI
Other - Middle Name:
Other - Last Name:EAPEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:900 E HILL AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37915-2566
Mailing Address - Country:US
Mailing Address - Phone:865-862-0998
Mailing Address - Fax:865-544-1861
Practice Address - Street 1:1415 OLD WEISGARBER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1327
Practice Address - Country:US
Practice Address - Phone:865-934-5800
Practice Address - Fax:865-934-5801
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD41548207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2101404OtherUNITED HEALTHCARE
VA010081424Medicaid
683237OtherNCPPO
7013613OtherAETNA PPO
282529OtherAMERIGROUP
61960002OtherBCBS CAREFIRST
3128998OtherMAMSI OPT CHOICE
VA010081416Medicaid
3607654OtherAETNA HMO
3607654OtherAETNA HMO
2101404OtherUNITED HEALTHCARE
005184M56Medicare ID - Type Unspecified
VA010081416Medicaid