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General NPI Number Information
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NPI Number | 1336051937
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Entity Type | Individual
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Provider Name | CHARLES MAKAKA
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Gender | Male
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 30 7TH ST W
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City | DICKINSON
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State | ND
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Zip | 58601-4335
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Country | US
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Telephone | 701-402-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 YELLOWSTONE CIR
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City | DICKINSON
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State | ND
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Zip | 58601-3001
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Country | US
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Telephone | 701-402-3335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | NDL171125
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License Number State | ND
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