MEDICARE: TODD MAKLER MD

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	2085R0204X	Vascular & Interventional Radiology Physician	MD035326L	PA
2	2085R0202X	Diagnostic Radiology Physician	MD035326L	PA

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

General Provider Information

NPI Number	:	1205826898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD MAKLER MD

Provider Business Mailing Address
First Line	:	4 NESHAMINY INTERPLEX
Second Line	:	SUITE 209
City	:	TREVOSE
State	:	PA
Zip	:	19053-6940
Country	:	US
Telephone Number	:	215-244-3070
Fax Number	:	215-638-9041

Provider Business Practice Location Address
First Line	:	3998 RED LION ROAD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-1436
Country	:	US
Telephone Number	:	215-612-4021
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	04/21/2009

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