Individual
MAKILZHAN SHANMUGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 MERCY DR NW, SUITE 101, CANTON, OH 44708-2626
(330) 588-4676
(330) 588-4677
Mailing address
1330 MERCY DR NW STE 101, CANTON, OH 44708-2624
(216) 472-2730
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35-074146
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110170325
MEDICARE RAILROAD
—
05
—
2094102
—
OH
Enumeration date
06/05/2006
Last updated
01/20/2021
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