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General NPI Number Information
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NPI Number | 1154481273
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Entity Type | Organization
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Legal Business Name | DAVID E DRAKE DO PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 1221 CENTER #3
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City | DES MOINES
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State | IA
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Zip | 50309-1014
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Country | US
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Telephone | 515-288-8000
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Fax | 515-288-4073
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Provider Business Mailing Address
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Address Line | 2213 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5305
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Country | US
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Telephone | 515-237-3974
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Fax | 515-883-2692
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Authorized Official
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Title or Position | PRES OWNER
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Name | DR. DAVID E DRAKE
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Credential | DO
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Telephone | 515-288-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 02908
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License Number State | IA
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