Healthcare Provider Details

I. General information

NPI: 1588689699
Provider Name (Legal Business Name): RAVINDER BAIMEEDI REDDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAVINDER REDDY BAIMEEDI M.D.

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9475 HIGHWAY 19 N
ZEBULON GA
30295-3189
US

IV. Provider business mailing address

9475 HIGHWAY 19 N
ZEBULON GA
30295-3189
US

V. Phone/Fax

Practice location:
  • Phone: 770-567-7500
  • Fax: 770-567-7503
Mailing address:
  • Phone: 770-567-7500
  • Fax: 770-567-7503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number063435
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: