Provider Demographics
NPI:1790866572
Name:BANDI, SAILAJA (MD)
Entity Type:Individual
Prefix:
First Name:SAILAJA
Middle Name:
Last Name:BANDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAILAJA
Other - Middle Name:
Other - Last Name:ANALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:657 HEMLOCK ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8329
Mailing Address - Country:US
Mailing Address - Phone:478-741-7241
Mailing Address - Fax:478-745-8932
Practice Address - Street 1:777 HEMLOCK ST
Practice Address - Street 2:MEDICAL CENTER OF CENTRAL GEORGIA
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2102
Practice Address - Country:US
Practice Address - Phone:478-213-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine