Provider Demographics
NPI:1588657365
Name:MAKHIJA, MANOJ (MD)
Entity Type:Individual
Prefix:DR
First Name:MANOJ
Middle Name:
Last Name:MAKHIJA
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 1:13634 N 93RD AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4915
Mailing Address - Country:US
Mailing Address - Phone:623-974-2434
Mailing Address - Fax:623-974-4925
Practice Address - Street 1:10192 W COGGINS DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3405
Practice Address - Country:US
Practice Address - Phone:623-974-2434
Practice Address - Fax:623-974-4925
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33083208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ874059Medicaid
AZ874059Medicaid
Z124124Medicare PIN
AZZ133517Medicare PIN
82634Medicare PIN