Provider Demographics
NPI:1508006859
Name:JAJODIA, ANILA SHYAM (MD)
Entity Type:Individual
Prefix:
First Name:ANILA
Middle Name:SHYAM
Last Name:JAJODIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3525 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 4330
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3937
Mailing Address - Country:US
Mailing Address - Phone:614-255-6900
Mailing Address - Fax:614-255-6901
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 4330
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-255-6900
Practice Address - Fax:614-255-6901
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35097030208M00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077745Medicaid