Healthcare Provider Details

I. General information

NPI: 1508006859
Provider Name (Legal Business Name): ANILA SHYAM JAJODIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 OLENTANGY RIVER RD SUITE 4330
COLUMBUS OH
43214-3937
US

IV. Provider business mailing address

3525 OLENTANGY RIVER RD SUITE 4330
COLUMBUS OH
43214-3937
US

V. Phone/Fax

Practice location:
  • Phone: 614-255-6900
  • Fax: 614-255-6901
Mailing address:
  • Phone: 614-255-6900
  • Fax: 614-255-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35097030
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number35097030
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: