Individual
MAKKALON EM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
761 JOHNSONBURG RD STE 240, SAINT MARYS, PA 15857-3480
(814) 781-1188
(814) 781-6828
Mailing address
761 JOHNSONBURG RD STE 240, SAINT MARYS, PA 15857-3480
(814) 781-8189
(814) 781-6828
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD455835
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD455835
PA LICENSE
PA
Enumeration date
04/13/2009
Last updated
12/12/2025
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