Individual
ALEXEY MAKOGONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 HERRICK ST, BEVERLY, MA 01915-1776
(978) 922-3000
Mailing address
BEVERLY HOSPITAL, 85 HERRICK STREET, BEVERLY, MA 01915-1790
(978) 922-3000
(978) 921-7048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
151220
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3157130
—
MA
Enumeration date
09/30/2005
Last updated
01/03/2019
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