Provider Demographics
NPI:1497040265
Name:MAKWANA, SHREYAS GIRISH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHREYAS
Middle Name:GIRISH
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 1:11820 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2830
Mailing Address - Country:US
Mailing Address - Phone:925-875-0700
Mailing Address - Fax:925-875-0576
Practice Address - Street 1:625 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-2409
Practice Address - Country:US
Practice Address - Phone:205-934-2307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-6090208600000X
CAA134283208200000X
ALMD-36195390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program