| George E. Drake, M.d., P.c. | |
|
1 S 5th St Niles MI 49120-2710 | |
| (269) 687-9607 | |
| Not Available |
| Full Name | George E. Drake, M.d., P.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1 S 5th St, Niles, Michigan |
| Authorized Official Name and Position | George Erving Drake (PRESIDENT OWNER) |
| Authorized Official Contact | 2696879607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| George E. Drake, M.d., P.c. 732 S 11th St Suite 100 #242 Niles MI 49120-3368 Ph: (269) 687-9607 | George E. Drake, M.d., P.c. 1 S 5th St Niles MI 49120-2710 Ph: (269) 687-9607 |
| NPI Number | 1013114552 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013114552 | NPI | - | NPPES |
| P00218423 | Other | MI | RR MEDICARE |
| 4731175 | Medicaid | MI | |
| 0801110581 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301034140 (Michigan) | Primary |
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