Provider Demographics
NPI:1235417387
Name:BHEEMISETTY, SHYAMALA DEEPTI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHYAMALA
Middle Name:DEEPTI
Last Name:BHEEMISETTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:990 S PROSPECT ST STE 3
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6283
Practice Address - Country:US
Practice Address - Phone:740-383-7910
Practice Address - Fax:740-375-8129
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110103482084P0800X
OH35.1347762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry