Individual
RAVEENA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1540
Mailing address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7001
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
783L
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
37720
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
74333
GA
Other
Enumeration date
03/10/2014
Last updated
09/14/2021
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