Provider Demographics
NPI:1972816718
Name:SARAI, JODHVIR (MD)
Entity type:Individual
Prefix:DR
First Name:JODHVIR
Middle Name:
Last Name:SARAI
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:PO BOX 73488
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-0488
Mailing Address - Country:US
Mailing Address - Phone:855-722-9700
Mailing Address - Fax:844-222-0800
Practice Address - Street 1:5728 MAJOR BLVD STE 603
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7963
Practice Address - Country:US
Practice Address - Phone:855-722-9700
Practice Address - Fax:844-222-0800
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47801207R00000X
FLME15707207R00000X
UT9730774-1205208M00000X
WAMD60919220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2112038Medicaid