Individual
SANJIV MAKHECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4799 ROSEBUD LN, NEWBURGH, IN 47630-9225
(812) 471-1591
(812) 471-6650
Mailing address
6249 E WALNUT ST, EVANSVILLE, IN 47715-7432
(260) 341-4540
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
02002198A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009672
ENCORE
—
01
—
000000195481
BCBS
IN
01
—
11100
PHP
—
05
—
2242666
—
OH
Enumeration date
12/06/2005
Last updated
07/08/2007
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