Maksportsmd
Maksportsmd is a healthcare organization registered as Sports Medicine (Family Medicine) Physician in Bothell, WA, holding Type 2 (organization) NPI 1417469404 since 2017. The authorized official on file is Abimbolu Makinde, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1417469404 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Maksportsmd |
| Practice address | 19110 BOTHELL WAY NE STE 102, Bothell, WA, 98011 |
| Phone | 4252868271 |
| Fax | 4254917271 |
| Enumeration date | 2017-10-30 |
| Last updated in NPPES | 2017-10-30 |
Authorized official
| Name | Abimbolu Makinde |
|---|---|
| Title | Owner |
| Phone | 4252868271 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207QS0010X | Sports Medicine (Family Medicine) Physician | Primary | 60465979 | WA |
Copy-ready billing details
Provider: Maksportsmd NPI: 1417469404 Taxonomy: 207QS0010X (Sports Medicine (Family Medicine) Physician) Address: 19110 BOTHELL WAY NE STE 102, Bothell, WA, 98011
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1669769337 | Abimbolu Makinde | Individual | Sports Medicine (Family Medicine) Physician | Bothell, WA |
Verify this record
Cross-check NPI 1417469404 against the authoritative CMS record: view Maksportsmd on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Maksportsmd located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2017-10-30.