Provider Demographics
NPI:1972767457
Name:BASU, RESHMI (MD)
Entity Type:Individual
Prefix:
First Name:RESHMI
Middle Name:
Last Name:BASU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTH PEDIATRICS & ADOLESCENT MEDICINE
Mailing Address - Street 2:6095 BARFIELD RD. SUITE 200
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-256-2688
Mailing Address - Fax:770-685-7114
Practice Address - Street 1:NORTH PEDIATRICS & ADOLESCENT MEDICINE
Practice Address - Street 2:6095 BARFIELD RD. SUITE 200
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-256-2688
Practice Address - Fax:770-685-7114
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.097518208000000X
AZR70175208000000X
CAA126120208000000X
GA79388208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR70175OtherTRAINING PERMIT