Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Cardiovascular Thoracic Surgery, PLC

Organization Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · NPI 1487760427

Great Lakes Cardiovascular Thoracic Surgery, PLC is a Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Portage, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006

Practice location Address checks out

7901 S 12th St Ste 201
Portage, MI 49024-3831
Phone: (269) 372-8687
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 5101009076 (MI)

Record details

NPI number1487760427
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official George Mack — President · (269) 372-8687
Other names Great Lakes Vein Center
NPI enumeratedAugust 22, 2006
Last updated in NPPESNovember 13, 2007
Mailing address7901 S 12th St, Suite 201, Portage, MI 49024-3831

Other providers in Portage