Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 2000100574 | NC |
N | 208800000X | Urologist | 32398 | SC |
NPI | 1003847310 |
---|---|
Provider Name | Mark Makhuli |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28204-2826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 05/01/2022 |