Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Great Lakes Plastic Reconstructive & Hand Surgery P C

Plastic Surgery Physician in Portage, MI · enumerated 2007 · authorized official Raghuram Elluru, Managing Partner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1336335785

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Registry record

Entity type Organization (Type 2)

Legal business name Great Lakes Plastic Reconstructive & Hand Surgery P C

Other name <Unavail>

Practice address 7971 Moorsbridge Rd, Portage, MI, 49024

Phone (269) 329-2900

Fax (269) 329-1408

Enumeration date Sep 19, 2007

Last updated in NPPES Apr 17, 2013

Taxonomy & classification

208200000X Plastic Surgery Physician Allopathic & Osteopathic Physicians · License RE07166 (MI) Primary

Authorized official

Name Raghuram Elluru

Title Managing Partner

Phone (269) 329-2900

Other identifiers

Identifier	Type	State	Issuer
0C90475	Other	MI	BLUE CROSS/BLUE SHIELD
103481434	Medicaid	MI	-
1629075668	Other	MI	DR ELLURU NPI
103481480	Medicaid	MI	-
1811994841	Other	MI	DR HOLLEY NPI
103481390	Medicaid	MI	-
0A30093	Other	MI	BLUE CROSS/BLUE SHIELD
103481443	Medicaid	MI	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2013-04-17. Verify at npiregistry.cms.hhs.gov.

Where is Great Lakes Plastic Reconstructive & Hand Surgery P C located?

The practice location on file with NPPES is in Portage, MI.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-04-17.