Alluri Raju, M.D.
Individual provider Active NPI General Practice Physician · Richland, GA
NPI 1508917451 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1508917451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 022626 (GA)
- Practice address
- 306 Alston St
Richland, GA 31825-1406 - Phone
- (229) 887-3351
- Fax
- (229) 887-2486
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100709000002 | GA | Practitioner - General Practice |
6709854573 | Practice locations: Richland, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022626 | GA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 022626 | GA | Yes |
Addresses
Primary practice location
306 Alston St
Richland, GA 31825-1406
Mailing address
306 Alston St
Richland, GA 31825-1406
Phone (229) 887-3351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000228687C | Medicaid | GA |
Other providers in Richland, GA
- New Horizons CSB Redhill Adult Group
- New Horizons CSB Stewart County C & a
- Rebecca Shepherd Ohearn
- Erin Nicole Pate
- Preston Family Clinic
- Richland Adult Day Center, LLC
- Carlos Cortez Seay
- Leslie Smith
- Rebecca Smith
- Suzanne Stark
All providers in Richland, GA · General Practice Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.