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

Great Lakes Plastic Reconstructive & Hand Surgery P C

Organization Plastic Surgery Physician · NPI 1336335785

Great Lakes Plastic Reconstructive & Hand Surgery P C is a Plastic Surgery Physician in Portage, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007

Practice location Address checks out

7971 Moorsbridge Rd
Portage, MI 49024-4075
Phone: (269) 329-2900
Fax: (269) 329-1408
Show map & directions

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

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence RE07166 (MI)

Record details

NPI number1336335785
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raghuram Elluru — Managing Partner · (269) 329-2900
Other names Great Lakes Plastic And Hand Surgery
NPI enumeratedSeptember 19, 2007
Last updated in NPPESApril 17, 2013
Mailing address7971 Moorsbridge Rd, Portage, MI 49024-4075

Other providers in Portage