Healthcare Provider Details

I. General information

NPI: 1841932845
Provider Name (Legal Business Name): DAVID JOSEPH MAKARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 OLD HENDERSON RD STE W-110
COLUMBUS OH
43220-3626
US

IV. Provider business mailing address

1550 OLD HENDERSON RD STE W-110
COLUMBUS OH
43220-3626
US

V. Phone/Fax

Practice location:
  • Phone: 234-260-6903
  • Fax:
Mailing address:
  • Phone: 234-260-6903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3114991
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: