MEDICARE: DR. JAYESH MAKIM 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	207R00000X	Internal Medicine Physician	3215	AK

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	0185721	OTHER	AK	WA DEPT L&I

General Provider Information

NPI Number	:	1801898473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYESH MAKIM MD

Provider Business Mailing Address
First Line	:	PO BOX 241889
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-1889
Country	:	US
Telephone Number	:	907-563-1777
Fax Number	:	907-561-7464

Provider Business Practice Location Address
First Line	:	3650 LAKE OTIS PKWY
Second Line	:	SUITE 205
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5207
Country	:	US
Telephone Number	:	907-561-1565
Fax Number	:	907-561-1541

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. JAYESH MAKIM MD” Practice Location

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