T Matthew Mak MD Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35044839 Issued in OH

Legal business name

T MATTHEW MAK MD INC

Practice address

2728 Lake Ave
Ashtabula, OH 44004-4960

Phone

(440) 992-7788

Fax

(440) 998-0388

NPI assigned

Feb 2, 2009

Last updated

Feb 4, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. T. Matthew Mak, M.D.

Title

Owner

Phone

(440) 992-7788

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1518105345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044960",
            "telephone_number": "440-992-7788",
            "fax_number": "440-998-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044960",
            "telephone_number": "440-992-7788",
            "fax_number": "440-998-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T MATTHEW MAK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "MAK",
        "authorized_official_first_name": "T. MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-992-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35044839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442444",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.