Individual
RAGHAVESH PULLALAREVU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 W 13 MILE RD STE 644, BEAUMONT MULTI-ORGAN TRANSPLANT CLINIC, ROYAL OAK, MI 48073-6770
(800) 253-5592
(248) 551-2125
Mailing address
130 TOWN CENTER DR STE 203, BEAUMONT MEDICAL STAFF AFFAIRS, TROY, MI 48084-1744
(248) 585-8218
(248) 585-8266
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT 198189
PA
207RN0300X
Nephrology Physician
Primary
4301110236
MI
Other
Enumeration date
06/30/2010
Last updated
06/23/2016
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