Provider Demographics
NPI:1801895966
Name:KANNEGENTI, RAMESH BABU (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:BABU
Last Name:KANNEGENTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6 YOSEMITE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-1730
Mailing Address - Country:US
Mailing Address - Phone:706-653-2889
Mailing Address - Fax:706-494-8220
Practice Address - Street 1:820 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9246
Practice Address - Country:US
Practice Address - Phone:706-653-2889
Practice Address - Fax:706-494-8220
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0404342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000876279BMedicaid
GA52493278OtherBLUE CROSS BLUE SHIELD
GA000876279BMedicaid
GAG65360Medicare UPIN