Great Lakes Plastic And Hand Surgery

LBN: Great Lakes Plastic Reconstructive & Hand Surgery P C
Great Lakes Plastic And Hand Surgery is an health care organization with primary practice located at 7971 Moorsbridge Rd , Portage MI 49024-4075. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Great Lakes Plastic Reconstructive & Hand Surgery P C can be contacted via phone (269) 329-2900, or through Elluru, Raghuram G via phone (269) 329-2900.

Contact Information

Primary practice address
7971 Moorsbridge Rd Portage MI 49024-4075
Phone: (269) 329-2900
Fax: (269) 329-1408
Website:
Map and Directions
Authorized official contact:
Name: Elluru, Raghuram G
Phone: (269) 329-2900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X RE07166 Michigan

Profile Details

NPI number 1336335785
LBN Legal business name Great Lakes Plastic Reconstructive & Hand Surgery P C
DBA Doing business as Great Lakes Plastic And Hand Surgery
Authorized official Elluru, Raghuram G
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2007
Last updated Apr 17th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336335785 NPPES
Michigan Other 0C90475 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 103481434 BLUE CROSS/BLUE SHIELD
Michigan Other 1629075668 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 103481480 BLUE CROSS/BLUE SHIELD
Michigan Other 1811994841 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 103481390 BLUE CROSS/BLUE SHIELD
Michigan Other 0A30093 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 103481443 BLUE CROSS/BLUE SHIELD

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