Elluru, Raghuram Gop

Elluru, Raghuram Gop is an individual health care provider with primary practice located at 7971 Moorsbridge Rd , Portage MI 49024-4075. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Elluru, Raghuram Gop can be contacted via phone (269) 329-2900.

Contact Information

Primary practice address
7971 Moorsbridge Rd Portage MI 49024-4075
Phone: (269) 329-2900
Fax: (269) 329-1408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X RE071666 Michigan
Allopathic & Osteopathic Physicians / Surgery of the Hand 2082S0105X RE071666 Michigan

Profile Details

NPI number 1629075668
LBN Legal business name Elluru, Raghuram Gop
Credentials M.D., F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2005
Last updated Apr 17th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629075668 NPPES
Michigan Other 0C90475 BLUE CROSS/BLUE SHIELD

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