Individual
REDDY BEESAM SHASHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST DEPT OF, AUGUSTA, GA 30912
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(314) 977-4850
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
080106
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003206806A
—
GA
01
—
080106
MEDICAL LICENSE
GA
Enumeration date
06/30/2014
Last updated
07/19/2018
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