Individual
SHIRLIE ANN REDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, ROOM 2144, AUGUSTA, GA 30912-0004
(706) 721-3873
(706) 721-7763
Mailing address
1824 WALTON WAY, AUGUSTA, GA 30904-3804
(706) 737-9250
(706) 733-0697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
032464
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000409714B
—
GA
05
—
000409714C
—
GA
01
—
048451
BCBS
GA
01
—
050091610
RRMEDICARE
GA
01
—
339274
WELLCARE CMO
GA
01
—
550789920
TRICARE
GA
05
—
G32464
—
SC
Enumeration date
11/13/2006
Last updated
08/26/2015
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