Organization
T MATTHEW MAK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T. MATTHEW MAK M.D. (OWNER)
(440) 992-7788
Entity
Organization
Contact information
Practice address
2728 LAKE AVE, ASHTABULA, OH 44004-4960
(440) 992-7788
(440) 998-0388
Mailing address
2728 LAKE AVE, ASHTABULA, OH 44004-4960
(440) 992-7788
(440) 998-0388
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35044839
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442444
—
OH
Enumeration date
02/02/2009
Last updated
02/04/2009
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