Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 5901002646 | MI |
Y | 213ES0131X | Foot Surgery | DP195976 | OR |
NPI | 1255784492 |
---|---|
Provider Name | Sunny Sajjad |
First Address | Leesburg, VA 20176-4488 |
Second Address | Leesburg, VA 20176-4488 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2016 |
Last Update Date | 26/08/2021 |