Provider Demographics
NPI:1023193240
Name:MAKWANA, GIRISH N (MD)
Entity Type:Individual
Prefix:DR
First Name:GIRISH
Middle Name:N
Last Name:MAKWANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613
Mailing Address - Country:US
Mailing Address - Phone:828-261-0467
Mailing Address - Fax:828-267-0599
Practice Address - Street 1:1224 COMMERCE ST SW
Practice Address - Street 2:SUITE A
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613
Practice Address - Country:US
Practice Address - Phone:828-261-0467
Practice Address - Fax:282-267-0599
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050536207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAC82362Medicare UPIN