Individual
DR. DAVID C MAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 645-4043
(304) 645-4713
Mailing address
PO BOX 671, LEWISBURG, WV 24901-0671
(304) 645-4043
(304) 645-4713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1286
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000683460
MTN STATE BCBS
WV
01
—
010089158
FEDERAL WKRS COMP/BL
WV
05
—
0118716000
—
WV
01
—
1058353
WV WORKERS' COMP
WV
01
—
288546
MAMSI
WV
01
—
300126636
RAILROAD MCARE
WV
01
—
462501
ANTHEM BCBS
—
01
—
55073865301
CHAMPUS
—
Enumeration date
10/26/2006
Last updated
10/03/2011
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