Healthcare Provider Details

I. General information

NPI: 1710036884
Provider Name (Legal Business Name): JOYCE DREW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 HICKORY ST
MELBOURNE FL
32901-1962
US

IV. Provider business mailing address

804 SCOTT NIXON MEMORIAL DR
AUGUSTA GA
30907-2464
US

V. Phone/Fax

Practice location:
  • Phone: 321-784-3700
  • Fax: 321-784-4090
Mailing address:
  • Phone: 706-650-0705
  • Fax: 706-650-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME51510
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: