Individual
DR. JOHN MAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 SCHANCK RD, SUTE 8A, FREEHOLD, NJ 07728
(732) 431-9544
(732) 431-9313
Mailing address
11350 MCCORMICK RD, EXECUTIVE PLAZA 1, STE. 501, HUNT VALLEY, MD 21031
(410) 329-1071
(410) 329-1054
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MA08226700
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA08226700
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
25MA08226700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112407SL4
MEDICARE INDIVIDUAL ID NUMBER
NJ
Enumeration date
03/01/2006
Last updated
06/18/2021
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