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NPI Code Detail

MEDICARE: MIRANDA RHONDA MAKULSKI DO

MEDICARE: MIRANDA RHONDA MAKULSKI DO
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
1207Q00000XFamily Medicine Physician5101015405MI

Other Identifiers

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

General Provider Information

NPI Number : 1164489316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA RHONDA MAKULSKI DO
Provider Business Mailing Address
First Line : DEPARTMENT 272801
Second Line : PO BOX 67000
City : DETROIT
State : MI
Zip : 48267-2728
Country : US
Telephone Number : 517-629-8311
Fax Number : 517-629-7952
Provider Business Practice Location Address
First Line : 2845 CAPITAL AVE SW STE 302
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-4187
Country : US
Telephone Number : 269-979-6333
Fax Number : 269-979-6333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 11/27/2023

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Directions to “ MIRANDA RHONDA MAKULSKI DO” Practice Location

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