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General NPI Number Information
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NPI Number | 1568448421
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Entity Type | Individual
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Provider Name | RAJASHAKHER P REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 10/02/2021
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Provider Practice Location Address
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Address Line | 560 BLUE HERON WAY
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City | ALPHARETTA
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State | GA
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Zip | 30004-2770
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Country | US
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Telephone | 404-692-3493
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Fax |
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Provider Business Mailing Address
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Address Line | 11675 GREAT OAKS WAY STE 150
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City | ALPHARETTA
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State | GA
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Zip | 30022-2497
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Country | US
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Telephone | 866-300-8512
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Fax | 800-613-8386
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 041934
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 041934
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 041934
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 041934
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License Number State | GA
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