Individual
ASIM MAKHDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 PLEASANT STREET, SUITE 5, BRADFORD, PA 16701
(814) 362-5701
(814) 362-5702
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(741) 669-2330
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
287870
NY
207X00000X
Orthopaedic Surgery Physician
Primary
MD456673
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04760550
—
NY
Enumeration date
09/09/2016
Last updated
07/19/2018
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