| Matthew T Draelos Md Pc | |
|
200 N Bryant Ave Suite 100 Edmond OK 73034-6273 | |
| (405) 330-2362 | |
| (405) 330-2363 |
| Full Name | Matthew T Draelos Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 N Bryant Ave, Edmond, Oklahoma |
| Authorized Official Name and Position | Matthew Theodore Draelos (OWNER/OPERATOR) |
| Authorized Official Contact | 4053302362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew T Draelos Md Pc 200 N Bryant Ave Suite 100 Edmond OK 73034-6273 Ph: (405) 330-2362 | Matthew T Draelos Md Pc 200 N Bryant Ave Suite 100 Edmond OK 73034-6273 Ph: (405) 330-2362 |
| NPI Number | 1821267717 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 10/22/2008 |
| Medicare PECOS PAC ID | 3072684786 |
|---|---|
| Medicare Enrollment ID | O20081017000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821267717 | NPI | - | NPPES |
| OKB5063 | Other | OK | MEDICARE TPAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 15748 (Oklahoma) | Primary |
| Provider Name | Matthew T Draelos |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1437221694 PECOS PAC ID: 7315939022 Enrollment ID: I20080701000286 |
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