Organization
GEORGE E. DRAKE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE ERVING DRAKE M.D. (PRESIDENT OWNER)
(269) 687-9607
Entity
Organization
Contact information
Practice address
1 S 5TH ST, NILES, MI 49120-2710
(269) 687-9607
Mailing address
732 S 11TH ST, SUITE 100 #242, NILES, MI 49120-3368
(269) 687-9607
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301034140
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0801110581
BCBS
MI
05
—
4731175
—
MI
01
—
P00218423
RR MEDICARE
MI
Enumeration date
06/28/2007
Last updated
08/22/2020
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