Provider Demographics
NPI:1679133136
Name:MAKLED, DENA (PA-C)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:MAKLED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:128 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1623
Practice Address - Country:US
Practice Address - Phone:734-475-8677
Practice Address - Fax:734-327-0826
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-07-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant