Individual
DR. MICHAEL MAK IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 378-2980
(812) 378-2982
Mailing address
115 W 19TH ST, INDIANAPOLIS, IN 46202-1310
(317) 924-4022
(317) 924-4233
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01068313A
IN
207RH0003X
Hematology & Oncology Physician
211790
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05679M
MEDICARE (NY)
NY
05
—
200991920
—
IN
Enumeration date
10/11/2006
Last updated
10/06/2010
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