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General NPI Number Information
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NPI Number | 1902970262
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Entity Type | Organization
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Legal Business Name | SYED A S MAKKI MD PC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 1201 STONE ST SUITE 4
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City | PORT HURON
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State | MI
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Zip | 48060-3563
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Country | US
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Telephone | 810-982-8484
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Fax | 810-982-8485
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Provider Business Mailing Address
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Address Line | 1201 STONE ST SUITE 4
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City | PORT HURON
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State | MI
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Zip | 48060-3563
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Country | US
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Telephone | 810-982-8484
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Fax | 810-982-8485
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. SYED A S MAKKI
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Credential | MD
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Telephone | 810-982-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301032112
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License Number State | MI
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