National Provider Identifier Database

RAGHURAM G ELLURU, M.D., F.A.C.S. – NPI #1629075668
Plastic and Reconstructive Surgery


Contact Information

RAGHURAM G ELLURU, M.D., F.A.C.S.
7971 MOORSBRIDGE RD
PORTAGE, MI49024-4075
Phone: 269-329-2900
Fax: 269-329-1408
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Plastic Surgery 208200000X
Surgery of the Hand 2082S0105X

* Indicates primary specialty

NPI Profile & details for RAGHURAM G ELLURU

NPI Number 1629075668
Credentials M.D., F.A.C.S.
Entity Individual
Enumeration date 07/06/2005
Last updated 03/11/2026 - About 3 months ago
Sole proprietor1 No
Identifiers
  • MI License #: 4301071666
  • MI License #: RE071666
  • MI Other: 0C90475 BLUE CROSS/BLUE SHIELD
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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