Dr. Raghuram Gop Elluru
Surgeon Plastic Hand Surgeon
7971 Moorsbridge Rd
Portage
, Michigan 49024-4075
Dr. Raghuram Gop Elluru
Surgeon Plastic Hand Surgeon
7971 Moorsbridge Rd
Portage
, Michigan 49024-4075
(269) 329-1408
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About
Features
Specialties
- Surgeon
- Plastic Hand Surgeon
Languages spoken
- English
Location
First Address
- Dr. Raghuram Gop Elluru
- 7971 Moorsbridge Rd
- Portage, MI
- Zip : 49024-4075
- Fax : (269) 329-1408
- Phone : (269) 329-2900
Second Address
- Dr. Raghuram Gop Elluru
- 7971 Moorsbridge Rd
- Portage, MI
- Zip : 49024-4075
- Fax : (269) 329-1408
- Phone : (269) 329-2900
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | RE071666 | MI |
| Y | 208600000X | Surgeon | RE071666 | MI |
| N | 2082S0105X | Plastic Hand Surgeon | RE071666 | MI |
National Provider Identifier
| NPI | 1629075668 |
|---|---|
| Provider Name | Dr. Raghuram Gop Elluru |
| First Address | Portage, MI 49024-4075 |
| Second Address | Portage, MI 49024-4075 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2005 |
| Last Update Date | 17/04/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0C90475 | BLUE CROSS/BLUE SHIELD (01) | MI |
| F27148 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.