Individual
DR. CHARLES E DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12345 MERCY BLVD, SAVANNAH, GA 31419-3436
(912) 927-3046
(912) 925-0597
Mailing address
12345 MERCY BLVD, SAVANNAH, GA 31419-3436
(912) 927-3046
(912) 925-0597
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21678
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00250841E
—
GA
01
—
21678
LICENSE
GA
Enumeration date
09/27/2006
Last updated
11/17/2022
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