Provider Demographics
NPI:1962089904
Name:MAKANJUOLA, SAMUEL O (DPM)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:O
Last Name:MAKANJUOLA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 PLAZA PROPERTIES BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1530
Mailing Address - Country:US
Mailing Address - Phone:614-219-9727
Mailing Address - Fax:380-444-3384
Practice Address - Street 1:3100 PLAZA PROPERTIES BLVD STE 340
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1530
Practice Address - Country:US
Practice Address - Phone:614-219-9727
Practice Address - Fax:380-444-3384
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH36.004138213ES0103X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery