Individual
MATTHEW THEODORE DRAELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N BRYANT AVE, SUITE 100, EDMOND, OK 73034-6273
(405) 330-2362
(405) 330-2363
Mailing address
200 N BRYANT AVE, SUITE 100, EDMOND, OK 73034-6273
(405) 330-2362
(405) 330-2363
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
15748
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OK401293
MEDICARE TPAN
OK
Enumeration date
11/14/2006
Last updated
10/22/2008
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