Potluri, Suresh
Potluri, Suresh is an individual health care provider with primary practice located at 815 Saint Joseph Dr , Saint Joseph MI 49085-2529. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Hospitalist, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Potluri, Suresh can be contacted via phone (269) 983-3455.Contact Information
Primary practice address
815 Saint Joseph Dr
Saint Joseph MI 49085-2529
Phone: (269) 983-3455
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4301093703 | Michigan |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 01086616A | Indiana |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 01086616A | Indiana |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 4301093703 | Michigan |
Profile Details
| NPI number | 1871757708 |
|---|---|
| LBN Legal business name | Potluri, Suresh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2008 |
| Last updated | Jan 23rd, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871757708 | NPPES |
| Michigan | Other | 340C910480 | BLUE CROSS BLUE SHIELD |
| Michigan | MEDICAID | 1871757708 | BLUE CROSS BLUE SHIELD |
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