MEDICARE: DR. CODY M DRAKE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	304	NC
2	213ES0103X	Foot & Ankle Surgery Podiatrist	0103000961	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649271602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CODY M DRAKE DPM

Provider Business Mailing Address
First Line	:	15 CLEVELAND AVE
Second Line	:	SUITE 9
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-632-5280
Fax Number	:	276-632-5257

Provider Business Practice Location Address
First Line	:	15 CLEVELAND AVE
Second Line	:	SUITE 9
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-632-5280
Fax Number	:	276-632-5257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	04/07/2021

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Directions to “ DR. CODY M DRAKE DPM” Practice Location

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