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NPI Code Detail

MEDICARE: MAKALLA BOGARDY

MEDICARE: MAKALLA BOGARDY
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
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator
3101Y00000XCounselorC.2507296-TRNEOH

General Provider Information

NPI Number : 1558051730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKALLA BOGARDY
Provider Business Mailing Address
First Line : 434 EASTLAND RD
Second Line :
City : BEREA
State : OH
Zip : 44017-1217
Country : US
Telephone Number : 440-234-2006
Fax Number :
Provider Business Practice Location Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-234-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2023
Last Update Date : 06/03/2026

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Directions to “ MAKALLA BOGARDY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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