Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 01050271A | IN |
N | 207XS0106X | Orthopaedic Hand Surgeon | 036095190 | IL |
NPI | 1295708659 |
---|---|
Provider Name | Dr. Richard L Makowiec |
First Address | Detroit, MI 48278-1076 |
Second Address | Indianapolis, IN 46237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 12/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300004539 | (05) | IN |
H00217 | (02) | IL |
P01161779 | RR MEDICARE (01) | IL |