Provider Demographics
NPI:1528385291
Name:SANDIFER KUM-NJI, JULIETTE LAGINGER (MD)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:LAGINGER
Last Name:SANDIFER KUM-NJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIETTE
Other - Middle Name:LAGINGER
Other - Last Name:SANDIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3807 W NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39209-2560
Mailing Address - Country:US
Mailing Address - Phone:601-292-9524
Mailing Address - Fax:601-895-0001
Practice Address - Street 1:4755 I 55 N
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-5602
Practice Address - Country:US
Practice Address - Phone:601-895-0000
Practice Address - Fax:601-895-0001
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA320680207RE0101X, 207RE0101X
MS24924207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism