Provider Demographics
NPI:1033410410
Name:DANIEL E MAKAS DO PA
Entity Type:Organization
Organization Name:DANIEL E MAKAS DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-677-3736
Mailing Address - Street 1:PO BOX 3269
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-3269
Mailing Address - Country:US
Mailing Address - Phone:410-677-3736
Mailing Address - Fax:410-677-0922
Practice Address - Street 1:540 RIVERSIDE DR
Practice Address - Street 2:STE 6
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5352
Practice Address - Country:US
Practice Address - Phone:410-677-3736
Practice Address - Fax:410-677-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0048241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD282500400Medicaid
MD282500400Medicaid
326RMedicare PIN