Provider Demographics
NPI:1891913232
Name:SAJJAD, WASEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:
Last Name:SAJJAD
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 1:100 W MCCREIGHT AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1890
Mailing Address - Country:US
Mailing Address - Phone:937-323-1404
Mailing Address - Fax:937-323-1407
Practice Address - Street 1:100 W MCCREIGHT AVE STE 150
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1890
Practice Address - Country:US
Practice Address - Phone:937-323-1404
Practice Address - Fax:937-323-1407
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002934-1208M00000X
NY258846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02921442Medicaid
NY209315BJOtherPREFERRED CARE
NYP010302934OtherROCHESTER BLUE CHOICE
NY02921442Medicaid
NYRB5460Medicare PIN
NY70005AMedicare PIN
NY209315BJOtherPREFERRED CARE
NYP010302934OtherROCHESTER BLUE CHOICE