Individual
KOTARO MAKINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 N RITTER AVE, INDIANAPOLIS, IN 46219-3027
(317) 355-1411
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01062209
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200868970
—
IN
Enumeration date
06/14/2007
Last updated
12/17/2024
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