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Individual

CHARLES R. DRAKE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1829 W. PLAZA DRIVE, WINCHESTER, VA 22601-6365
(540) 667-6161
(540) 722-2744
Mailing address
1829 W. PLAZA DRIVE, WINCHESTER, VA 22601-6365
(540) 667-6161
(540) 722-2744

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101035745
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
0101035745
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006041647
VA
01
110028381
MEDICARE RR
05
1725296502
VA
Enumeration date
04/20/2006
Last updated
02/28/2011
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