| Robert L Drake Md | |
|
1619 N Greenwood Ste 107 Pueblo CO 81003 | |
| (719) 545-0182 | |
| (719) 545-1332 |
| Full Name | Robert L Drake Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 1619 N Greenwood, Pueblo, Colorado |
| Authorized Official Name and Position | Robert Lewis Drake (OWNER) |
| Authorized Official Contact | 7195450182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert L Drake Md 1619 N Greenwood Ste 107 Pueblo CO 81003 Ph: (719) 545-0182 | Robert L Drake Md 1619 N Greenwood Ste 107 Pueblo CO 81003 Ph: (719) 545-0182 |
| NPI Number | 1366469306 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366469306 | NPI | - | NPPES |
| 01239128 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | CO23912 (Colorado) | Primary |
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