Provider Demographics
NPI:1922363738
Name:GADREY, MAKARAND MUKUND (MD)
Entity Type:Individual
Prefix:
First Name:MAKARAND
Middle Name:MUKUND
Last Name:GADREY
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 1:8201 16TH ST
Mailing Address - Street 2:APT.318
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3240
Mailing Address - Country:US
Mailing Address - Phone:202-679-0227
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-8278
Practice Address - Fax:202-877-6292
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-08
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD79047208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program