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General NPI Number Information
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NPI Number | 1366717837
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Entity Type | Individual
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Provider Name | MICHAEL JONATHAN DRAKOS L.AC.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2012
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Last Update Date | 03/17/2012
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Provider Practice Location Address
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Address Line | 601 POST OFFICE RD STE 2D
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City | WALDORF
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State | MD
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Zip | 20602-1912
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Country | US
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Telephone | 301-848-0461
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Fax | 301-885-0922
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Provider Business Mailing Address
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Address Line | 5182 DOWNWEST RIDE
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City | COLUMBIA
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State | MD
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Zip | 21044-1505
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Country | US
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Telephone | 410-707-0661
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U01971
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License Number State | MD
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