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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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