Individual
DR. SURESH POTLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 GULL RD, KALAMAZOO, MI 49048-1609
(269) 633-2510
(269) 633-2511
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301093703
MI
208800000X
Urology Physician
01086616A
IN
208800000X
Urology Physician
Primary
4301093703
MI
208M00000X
Hospitalist Physician
01086616A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871757708
—
MI
01
—
340C910480
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/10/2008
Last updated
08/07/2026
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