Provider Demographics
NPI:1265482111
Name:MAKAM, SATYAPRAKASH N (MD)
Entity Type:Individual
Prefix:DR
First Name:SATYAPRAKASH
Middle Name:N
Last Name:MAKAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PRAKASH
Other - Middle Name:N
Other - Last Name:MAKAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10010 DONALD POWERS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-934-4200
Mailing Address - Fax:219-934-6240
Practice Address - Street 1:10010 DONALD POWERS DRIVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-934-4200
Practice Address - Fax:219-934-6240
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031764A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200103460AMedicaid
IN707050CMedicare PIN
INE08125Medicare UPIN