DR. RAGHURAM GOP ELLURU (NPI# 1629075668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629075668 |
| Entity Type | Individual |
| Full Name | DR. RAGHURAM GOP ELLURU |
| Credential | M.D., F.A.C.S. |
| Practice Address |
7971 Moorsbridge Rd Portage MI 49024-4075 |
| Practice Telephone | 2693292900 |
| Practice Fax Number | 2693291408 |
| Mailing Telephone | 2693292900 |
| Mailing Fax Number | 2693291408 |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2013-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | RE071666 | MI | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
RE071666 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS/BLUE SHIELD | 0C90475 | 01 |
| Street Address |
7971 MOORSBRIDGE RD |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-4075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811994841 | Scott Donald Holley | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2005-07-06 |
| 1366976912 | Kyle L Purdum | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2017-04-19 |
| 1720538341 | Southwest Michigan Plastic and Hand Surgery, PC | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2016-10-06 |
| 1386027977 | Diana Calderon | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2015-07-01 |
| 1992197925 | Three Rivers Health System, Inc | Podiatrist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2015-02-27 |
| 1386987311 | Kristina Machiri | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2013-03-27 |
| 1215181557 | Craig Michael Bradfield | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2008-11-13 |
| 1336335785 | Great Lakes Plastic Reconstructive & Hand Surgery P C | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2007-09-19 |
| 1316169303 | Bryan Lee Herder | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2007-05-02 |
| 1760603427 | Nancy Ellen Krolikowski | Occupational Therapist | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2007-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811994841 | Scott Donald Holley | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2005-07-06 |
| 1720538341 | Southwest Michigan Plastic and Hand Surgery, PC | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2016-10-06 |
| 1689818486 | Kimberly Clawson | Plastic Surgery | 7901 S 12th St, Portage, MI 49024 | 2009-04-23 |
| 1336335785 | Great Lakes Plastic Reconstructive & Hand Surgery P C | Plastic Surgery | 7971 Moorsbridge Rd, Portage, MI 49024-4075 | 2007-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285100719 | Nuvantage Wound Care Solutions Pllc | Plastic Surgery | 21717 Rose Hollow Dr, Southfield, MI 48075-5508 | 2018-10-23 |
| 1134614886 | Landmark Surgery Center | Plastic Surgery | 26850 Providence Pkwy Ste 125b, Novi, MI 48374-1253 | 2018-06-26 |
| 1194102467 | Matthew Kenneth Shaheen | Plastic Surgery | 28050 Grand River Ave Ste 518, Farmington Hills, MI 48336-5919 | 2015-05-06 |
| 1649675174 | Executive Plastic Surgery, Pllc | Plastic Surgery | 26850 Providence Pkwy Ste 125, Novi, MI 48374-1253 | 2014-10-27 |
| 1891109971 | John Philip Kelpin Jr. | Plastic Surgery | 221 Michigan St Ne # Mc106, Suite 200a, Grand Rapids, MI 49503-2543 | 2014-06-17 |
| 1891108759 | Jeffrey Thomas Desano II | Plastic Surgery | 31100 Telegraph Rd Ste 280, Bingham Farms, MI 48025 | 2014-06-09 |
| 1518306315 | Sarah M Elswick | Plastic Surgery | 201 W Big Beaver Rd Ste 1130, Troy, MI 48084-5298 | 2013-06-14 |
| 1730527326 | Advanced Plastic Surgery, PC | Plastic Surgery | 4551 Cascade Rd Se, Suite D, Grand Rapids, MI 49546-8372 | 2013-06-05 |
| 1396095568 | Cascade Plastic Surgery Plc | Plastic Surgery | 1514 Fourth St, Jackson, MI 49203-4032 | 2012-09-14 |
| 1013262476 | Ahmet R Karaca Md PC | Plastic Surgery | 101 Townsend St, Birmingham, MI 48009-6001 | 2012-07-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. RAGHURAM GOP ELLURU.
| 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.