Provider Demographics
NPI:1184824450
Name:MAKI, JUNSUKE (MD)
Entity Type:Individual
Prefix:
First Name:JUNSUKE
Middle Name:
Last Name:MAKI
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 1:1907 HIGHWAY 35
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755
Mailing Address - Country:US
Mailing Address - Phone:732-517-0060
Mailing Address - Fax:732-548-7408
Practice Address - Street 1:1907 HIGHWAY 35
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755
Practice Address - Country:US
Practice Address - Phone:732-517-0060
Practice Address - Fax:732-548-7408
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08722900207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology