Healthcare Provider Details

I. General information

NPI: 1083615033
Provider Name (Legal Business Name): ASEK NELSON MAKIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10274 LAKE ARBOR WAY STE 201
MITCHELLVILLE MD
20721-3146
US

IV. Provider business mailing address

PO BOX 429
BURTONSVILLE MD
20866-0429
US

V. Phone/Fax

Practice location:
  • Phone: 301-324-7338
  • Fax:
Mailing address:
  • Phone: 301-324-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD16084
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0032003
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberD0032003
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: