Individual ProviderSajiv AliasFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1439 Jesse Jewell Pkwy NE Ste 102, Gainesville, GA 30501-3806(770) 219-9445(770) 219-8420PECOS EnrollmentBased on the most recent information from CMS, provider Sajiv Alias is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1992266910Provider TypeIndividualFull NameAlias, SajivTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/31/2019Last Updated9/8/2023Contact InformationPractice LocationPractice Address1439 Jesse Jewell Pkwy NE Ste 102, Gainesville, GA 30501-3806Phone(770) 219-9445FaxUnlisted FaxMailing LocationMailing AddressPO Box 742616, Atlanta, GA 30374-2616Phone(770) 219-8420FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense96458GeorgiaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense82306South CarolinaCode207QS0010XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense82306South CarolinaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer