Provider Demographics
NPI:1689879660
Name:MAKKI, SYED A S (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:A S
Last Name:MAKKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1201 STONE ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3563
Mailing Address - Country:US
Mailing Address - Phone:810-982-8484
Mailing Address - Fax:810-982-8485
Practice Address - Street 1:1201 STONE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3563
Practice Address - Country:US
Practice Address - Phone:810-982-8484
Practice Address - Fax:810-982-8485
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2013-12-26
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Provider Licenses
StateLicense IDTaxonomies
MI43010321122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB45121Medicare UPIN