MEDICARE: DR. VYACHESLAV MAKAROV D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3522	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053572511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VYACHESLAV MAKAROV D.P.M

Provider Business Mailing Address
First Line	:	2817 ROCK MERRIT AVE STOP A
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	917-324-0919
Fax Number	:

Provider Business Practice Location Address
First Line	:	WOMACK ARMY MEDICAL CENTER 2817 ROCK MERRIT AVE STOP A
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-4845
Country	:	US
Telephone Number	:	910-907-8666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	04/30/2025

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