Individual
DR. RENEETA BASU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
615 BEAVER RUIN RD NW, LILBURN, GA 30047-3401
(770) 935-8616
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
85232
GA
207Q00000X
Family Medicine Physician
OS16141
FL
390200000X
Student in an Organized Health Care Education/Training Program
OT015694
PA
Other
Enumeration date
04/14/2014
Last updated
12/03/2025
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