Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 071860 | GA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2007-00868 | NC |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 37501 | SC |
NPI | 1154532331 |
---|---|
Provider Name | Dr. Keisha L.b. Reddick |
First Address | Savannah, GA 31404-6268 |
Second Address | Savannah, GA 31404-6200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2007 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003146294A | (05) | GA |
003146294B | (05) | GA |
P01321567 | RAILROAD MEDICARE (01) | GA |
Q68007 | (05) | SC |