Potluri, Rajendra

Potluri, Rajendra is an individual health care provider with primary practice located at 801 Broadway N , Fargo ND 58102-3641. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Potluri, Rajendra can be contacted via phone (701) 234-2731.

Contact Information

Primary practice address
801 Broadway N Fargo ND 58102-3641
Fax: (701) 234-2158
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 9227 North Dakota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 9227 North Dakota

Profile Details

NPI number 1679562953
LBN Legal business name Potluri, Rajendra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2005
Last updated Oct 14th, 2021 - about 3 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 1679562953 NPPES
North Dakota Other 22610 BLUE SHIELD
North Dakota MEDICAID 12271 BLUE SHIELD
North Dakota Other 28580 BLUE SHIELD
North Dakota Other CF8850 BLUE SHIELD
North Dakota Other 28582 BLUE SHIELD
North Dakota Other 28579 BLUE SHIELD
North Dakota Other 28581 BLUE SHIELD
North Dakota Other 25978 BLUE SHIELD
North Dakota Other 28583 BLUE SHIELD
North Dakota Other P00003010 BLUE SHIELD

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