MEDICARE: DR. ANIL K MAKANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	15545	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	020029777	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619067139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANIL K MAKANI MD

Provider Business Mailing Address
First Line	:	PO BOX 788
Second Line	:
City	:	PETERSBURG
State	:	WV
Zip	:	26847-0788
Country	:	US
Telephone Number	:	304-257-4331
Fax Number	:	304-257-2891

Provider Business Practice Location Address
First Line	:	65 HOSPITAL DR STE 103
Second Line	:
City	:	PETERSBURG
State	:	WV
Zip	:	26847-9549
Country	:	US
Telephone Number	:	304-257-4331
Fax Number	:	304-257-1115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	03/04/2020

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Directions to “ DR. ANIL K MAKANI MD” Practice Location

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