Individual
DR. MARK ANTHONY DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2007006286
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205471600
—
MO
01
—
P00432176
RAILROAD MEDICARE
MO
Enumeration date
03/19/2007
Last updated
03/14/2017
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