Healthcare Provider Details

I. General information

NPI: 1184601080
Provider Name (Legal Business Name): DAVID F DRAKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 5 MILE RD SUITE 310
CINCINNATI OH
45230-2163
US

IV. Provider business mailing address

4380 MALSBARY RD SUITE 200
CINCINNATI OH
45242-5644
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-0120
  • Fax: 513-232-8483
Mailing address:
  • Phone: 513-366-4488
  • Fax: 513-366-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35031757
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: