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Individual

DR. GEORGE ERVING DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
68449 SCOTT ST, EDWARDSBURG, MI 49112-9504
(269) 699-5776
Mailing address
68449 SCOTT ST, EDWARDSBURG, MI 49112-9504
(269) 699-5776

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301034140
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0801110581
BCBS
05
4731175
MI
01
P00218423
RR MEDICARE
Enumeration date
06/22/2006
Last updated
04/02/2013
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