Individual
MICHAEL DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 WASHINGTON AVE, ST MARY'S MEDICAL CENTER ANESTHESIA DEPT, EVANSVILLE, IN 47750
(812) 485-4000
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01028948A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01028948A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000040944
BLUE SHIELD
IN
01
—
050002640
RAILROAD MEDICARE
—
05
—
100247010
—
IN
05
—
64755606
—
KY
Enumeration date
06/09/2006
Last updated
05/26/2011
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