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General NPI Number Information
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NPI Number | 1124655600
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Entity Type | Individual
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Provider Name | PETER DRAKE MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 483 W SEED FARM RD
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City | SACATON
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State | AZ
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Zip | 85147-5000
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Country | US
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Telephone | 602-528-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 9878 W BELLEVIEW AVE # 5114
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City | LITTLETON
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State | CO
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Zip | 80123-2101
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Country | US
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Telephone | 844-466-6827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 04-49555
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 72985
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DR.0071785
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License Number State | CO
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