Provider Demographics
NPI:1215947585
Name:JACOB, SAJI (MD)
Entity type:Individual
Prefix:
First Name:SAJI
Middle Name:
Last Name:JACOB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:844 NORTH NEW BALLAS COURT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7205
Mailing Address - Country:US
Mailing Address - Phone:314-473-1285
Mailing Address - Fax:314-473-1287
Practice Address - Street 1:844 NORTH NEW BALLAS COURT
Practice Address - Street 2:SUITE 300
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7205
Practice Address - Country:US
Practice Address - Phone:314-473-1285
Practice Address - Fax:314-473-1287
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2004003233207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology