| NPI | 1336335785 |
|---|---|
| Doing Business As | GREAT LAKES PLASTIC AND HAND SURGERY |
| Entity Type | Organization |
| Authorized Contact | RAGHURAM G ELLURU Managing Partner 269-329-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI RE07166) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2013-04-17 |