Provider Demographics
NPI:1619107794
Name:KARAKATTU, SAJIN MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:SAJIN MATHEW
Middle Name:
Last Name:KARAKATTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 MULKEY RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1114
Mailing Address - Country:US
Mailing Address - Phone:770-422-1372
Mailing Address - Fax:770-999-2599
Practice Address - Street 1:1664 MULKEY RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1114
Practice Address - Country:US
Practice Address - Phone:770-422-1372
Practice Address - Fax:770-999-2599
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA88169207RP1001X, 207RC0200X
TN48888208M00000X, 207P00000X, 207Q00000X
VA0101251018207Q00000X, 208M00000X
TNMD48888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV6840BMedicare PIN
TN103I932285Medicare PIN