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NPI Code Detail

MEDICARE: ALI MAKLED OD

MEDICARE: ALI MAKLED OD
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
1152W00000XOptometrist4901005761MI

General Provider Information

NPI Number : 1376388033
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALI MAKLED OD
Provider Business Mailing Address
First Line : 5870 GOLFVIEW DR
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2483
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 35184 CENTRAL CITY PKWY
Second Line :
City : WESTLAND
State : MI
Zip : 48185-6215
Country : US
Telephone Number : 734-427-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2024
Last Update Date : 06/26/2024

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