Individual
DR. LISA RENE' DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
870 SADDLE HILL RD, ROSWELL, GA 30075-1249
(770) 640-9133
Mailing address
655 COLEBROOK CT NW, SANDY SPRINGS, GA 30327-4710
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000741518O
—
GA
Enumeration date
04/21/2006
Last updated
10/26/2012
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