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Individual

FRED DUANE DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1429 N 6TH ST, TERRE HAUTE, IN 47807-1037
(812) 242-3170
(812) 235-3330
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3170
(812) 235-3330

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01024937A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089620
ANTHEM
01
0182870
US DEPT OF LABOR
01
040004682
RAILROAD MCARE PALAMETTO
05
100250540
IN
Enumeration date
08/25/2006
Last updated
03/14/2013
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