Individual
SUDHAKARA BABU CHENNAREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 S ENOTA DR NE STE 100, GAINESVILLE, GA 30501-3466
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
079242
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64036478
—
KY
Enumeration date
07/18/2005
Last updated
12/08/2020
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