Individual
SANDEEP MELLACHERUVU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5826
(601) 984-5885
Mailing address
705 NAYLOR LN, RIDGELAND, MS 39157-1288
(601) 984-5826
(601) 984-5885
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
624-L
MS
Other
Enumeration date
06/23/2007
Last updated
07/08/2007
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