Individual
JONATHAN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, APC 5, PROVIDENCE, RI 02903-4923
(401) 444-6440
(401) 444-6858
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD15921
RI
Other
Enumeration date
05/30/2013
Last updated
06/25/2018
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