Individual
DR. RAJENDRA POTLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2731
(701) 234-2158
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9227
ND
208M00000X
Hospitalist Physician
Primary
9227
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12271
—
ND
01
—
22610
BLUE SHIELD
ND
01
—
25978
BLUE SHIELD
ND
01
—
28579
BLUE SHIELD
ND
01
—
28580
BLUE SHIELD
ND
01
—
28581
BLUE SHIELD
ND
01
—
28582
BLUE SHIELD
ND
01
—
28583
BLUE SHIELD
ND
01
—
CF8850
RAILROAD MEDICARE
ND
01
—
P00003010
RAILROAD MEDICARE
ND
Enumeration date
10/19/2005
Last updated
10/14/2021
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