DR. SURESH POTLURI (NPI# 1871757708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871757708 |
Entity Type | Individual |
Full Name | DR. SURESH POTLURI |
Credential | M.D. |
Practice Address |
1535 Gull Rd Suite 150 Kalamazoo MI 49048-1650 |
Mailing Address |
1521 Gull Rd Suite 150 Kalamazoo MI 49048-1640 |
Practice Telephone | 2693499745 |
Practice Fax Number | 2693497378 |
Mailing Telephone | 2693499745 |
Mailing Fax Number | 2693497378 |
Enumeration Date | 2008-07-10 |
Last Update Date | 2020-10-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 4301093703 | MI | Other Service Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BLUE CROSS BLUE SHIELD | 340C910480 | 01 |
MI | 1871757708 | 05 |
Street Address |
1535 GULL RD SUITE 150 |
City | KALAMAZOO |
State | MI |
Zip Code | 49048-1650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649273855 | Umakant Shivlal Doctor | Internal Medicine | 1535 Gull Rd, Ste 110, Kalamazoo, MI 49048-1630 | 2005-05-23 |
1417489931 | Katheryn Elisabeth Clark | Advanced Practice Midwife | 1535 Gull Rd, Suite 250, Kalamazoo, MI 49048-1650 | 2017-04-03 |
1649714452 | Susan Doan | Physician Assistant | 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 | 2016-12-13 |
1144673070 | Kristen Dib | Advanced Practice Midwife | 1535 Gull Rd, Kalamazoo, MI 49048-1650 | 2016-07-15 |
1366897670 | Kalamazoo Acute Care Specialists Plc | Emergency Medicine | 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 | 2016-04-25 |
1841670510 | Elizabeth Bobo | Nurse Practitioner | 1535 Gull Rd, Suite 150, Kalamazoo, MI 49048-1650 | 2015-06-08 |
1194163246 | Tabitha Jane Ewert | Physician Assistant | 1535 Gull Rd, Suite 200, Kalamazoo, MI 49048-1650 | 2013-06-11 |
1578858676 | Michael Robert Mcbride | Emergency Medicine | 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 | 2011-06-16 |
1295979474 | Lewis Jeremy Johnson | Surgery | 1535 Gull Rd, Suite 150, Kalamazoo, MI 49048-1650 | 2009-05-01 |
1134361215 | Michael Lee Adix II | Radiology | 1535 Gull Rd, Suite #200, Kalamazoo, MI 49048-1650 | 2009-04-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790214146 | Sally Leigh Weigandt | Technician, Other | 5438 Lucerne Ave, Kalamazoo, MI 49048 | 2017-06-08 |
1437606670 | Amanda Ezekiel | Advanced Practice Midwife | 1523 Gull Rd Ste 250, Kalamazoo, MI 49048 | 2016-09-06 |
1700238987 | Brittany Bittenbender | Technician, Other | 5840 E Cork St, Kalamazoo, MI 49048 | 2016-07-12 |
1255747176 | Araena Payton | Early Intervention Provider Agency | 1313 Hotop Ave, Kalamazoo, MI 49048 | 2014-07-11 |
1508297151 | Hope Network Eastwood House | Residential Treatment Facility, Physical Disabilities | 2236 Brook Drive, Kalamazoo, MI 49048 | 2013-12-09 |
1457780314 | Hope Network Rehabilitation Servicesq | Residential Treatment Facility, Physical Disabilities | 2236 Brooke Drive, Kalamazoo, MI 49048 | 2013-11-01 |
1467889576 | Aaron Van Heest | Social Worker | 813 Chrysler St., Kalamazoo, MI 49048 | 2013-10-03 |
1760737308 | Salem A. Salem | Internal Medicine | Ascension Borgess Hospital, 1521 Gull Rd, Kalamazoo, MI 49048 | 2012-07-19 |
1356523229 | Borgess Medical Center | Psychiatry & Neurology | 1521 Gull Road, Kalamazoo, MI 49048 | 2007-12-03 |
1629290135 | Robert Claude Gano | Dentist | 5462 Gull Rd Suite 7, Kalamazoo, MI 49048 | 2007-05-03 |
Find all providers in zip 49048 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174913420 | Teesha Lynn Bancroft | Specialist | 329 S Sage St, Kalamazoo, MI 49006 | 2015-01-26 |
1003213893 | Body Center Kalamazoo | Specialist | 2042 W Main St, Kalamazoo, MI 49006-3041 | 2014-11-23 |
1407263916 | Troy Lebiecki | Specialist | 6126 Crestwood Ave, Kalamazoo, MI 49048-9444 | 2014-07-16 |
1629343884 | Shannon Leigh Oehmke | Specialist | 8145 Waterwood Dr, Kalamazoo, MI 49048-9260 | 2012-03-20 |
1962661470 | Amanda R Edgar | Specialist | 910 Pinehurst Blvd, Kalamazoo, MI 49006-2111 | 2008-06-09 |
1538204169 | Oncology & Hematology PC | Specialist | 5010 Gull Rd Ste A, Kalamazoo, MI 49048-1093 | 2007-02-21 |
1609929587 | Jennifer Jean Chowaniec Gormley | Specialist | 5385 Swallow Ave, Kalamazoo, MI 49009-4501 | 2007-01-22 |
1245248756 | Jennifer Jones Hollings | Specialist | 1535 Gull Rd Ste 250, Kalamazoo, MI 49048-1661 | 2006-08-03 |
1841216355 | Premier Medical Care PC | Specialist | 1722 Gull Rd, Suite 1b, Kalamazoo, MI 49048-1644 | 2006-07-15 |
1730137720 | Alan Colestock | Specialist | 7000 Portage Rd, Kalamazoo, MI 49001-0102 | 2006-05-04 |
Find all providers in KALAMAZOO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.