Individual
DR. MARY DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 585-5000
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 585-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10334
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3502642
—
MT
01
—
P00028076
MEDICARE RAILROAD
—
Enumeration date
08/08/2006
Last updated
10/12/2007
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