Provider Demographics
NPI:1972569119
Name:SAUJANI, KESHMA (MD)
Entity type:Individual
Prefix:
First Name:KESHMA
Middle Name:
Last Name:SAUJANI
Suffix:
Gender:F
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:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-297-2200
Practice Address - Fax:770-534-8139
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235173207VX0000X
GA058218207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2514863OtherUHC
GA362599OtherWELLCARE
GA532279453EMedicaid
GA532279453CMedicaid
GA7486787OtherAETNA
GA10065357OtherAMERIGROUP
GA52205811OtherBCBS
GA532279453BMedicaid
GA532279453AMedicaid
GA532279453DMedicaid
GA4711545OtherCIGNA
GA532279453DMedicaid
GA7486787OtherAETNA