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Great Lakes Plastic Reconstructive & Hand Surgery P C
Plastic Surgery Physician in Portage, Michigan
NPI 1336335785

Great Lakes Plastic Reconstructive & Hand Surgery P C is a Plastic Surgery Physician based in Portage, MI. Great Lakes Plastic Reconstructive & Hand Surgery P C practices in Portage, MI. The NPI Number for Great Lakes Plastic Reconstructive & Hand Surgery P C is 1336335785 and holds a License No. RE07166 (Michigan).

The current practice location address for Great Lakes Plastic Reconstructive & Hand Surgery P C is 7971 Moorsbridge Rd, Portage, MI and can be reached out via phone at 269-329-2900 and via fax at 269-329-1408.

Location: 7971 Moorsbridge Rd, Portage, MI, 49024-4075
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336335785
Provider Name
Great Lakes Plastic Reconstructive & Hand Surgery P C
Credential
Provider Entity Type
Organization
Address
7971 Moorsbridge Rd, Portage, MI, 49024-4075
Phone Number
269-329-2900
Fax Number
269-329-1408
Provider Enumeration Date
09/19/2007
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
0C90475 01 MI BLUE CROSS/BLUE SHIELD
103481434 05 MI
1629075668 01 MI DR ELLURU NPI
103481480 05 MI
1811994841 01 MI DR HOLLEY NPI
103481390 05 MI
0A30093 01 MI BLUE CROSS/BLUE SHIELD
103481443 05 MI
institution
Provider Business Practice Location Address Details
Address
7971 Moorsbridge Rd
City
Portage
State
Michigan
Zip
49024-4075
Phone Number
269-329-2900
Fax Number
269-329-1408
person
Provider Business Mailing Address Details
Address
7971 Moorsbridge Rd
City
Portage
State
Michigan
Zip
49024-4075
Phone Number
269-329-2900
Fax Number
269-329-1408
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Plastic Surgery
Speciality
-
Taxonomy
208200000X
License No.
RE07166 (Michigan)
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
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Raghuram Gop Elluru
NPI 1629075668
Plastic Surgery Physician
7971 Moorsbridge Rd,
PORTAGE, MI
49024-4075
269-329-2900
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