Provider Demographics
NPI:1790729697
Name:MAKHNI, MALVINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:MALVINDER
Middle Name:S
Last Name:MAKHNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:980 HIGHWAY 28
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3695
Mailing Address - Country:US
Mailing Address - Phone:423-942-1415
Mailing Address - Fax:423-942-1416
Practice Address - Street 1:980 HIGHWAY 28
Practice Address - Street 2:SUITE 101
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3695
Practice Address - Country:US
Practice Address - Phone:423-942-1415
Practice Address - Fax:423-942-1416
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN45663207RC0000X
WI70431-20207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517945Medicaid
WI100084943Medicaid