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General NPI Number Information
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NPI Number | 1710771613
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Entity Type | Individual
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Provider Name | JESSICA KARLA SAJOR
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Gender | Female
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 145 SUNSET CT STE 100
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-2464
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Country | US
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Telephone | 803-739-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 827 FOREST PARK RD
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City | COLUMBIA
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State | SC
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Zip | 29209-2581
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Country | US
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Telephone | 843-323-5208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL94607
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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