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General NPI Number Information
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NPI Number | 1861620353
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Entity Type | Individual
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Provider Name | YELENA RANIKA MAKORI M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 6025 PROFESSIONAL PKWY STE 200
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5610
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Country | US
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Telephone | 770-949-0555
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Fax | 770-949-4424
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Provider Business Mailing Address
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Address Line | 905 DIXIE ST
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City | CARROLLTON
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State | GA
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Zip | 30117-4417
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Country | US
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Telephone | 770-812-5831
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0116023998
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116023998
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 068637
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License Number State | GA
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