Provider Demographics
NPI:1750591764
Name:SAJJA, VENU (MD)
Entity type:Individual
Prefix:DR
First Name:VENU
Middle Name:
Last Name:SAJJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:770-528-9938
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:770-528-9938
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA59928207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA430823643EMedicaid
GA430823643FMedicaid
GA430823643NMedicaid
GA430823643IMedicaid
GA430823643IMedicaid
GA202I063457Medicare PIN
GA430823643HMedicaid