MEDICARE: DAVID F DRAKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35031757	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0641478	OTHER		AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	31757-06	OTHER		HUMANA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	25-20413	OTHER		UNITED
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	000000215208	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1184601080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID F DRAKE M.D.

Provider Business Mailing Address
First Line	:	4380 MALSBARY RD
Second Line	:	SUITE 200
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5644
Country	:	US
Telephone Number	:	513-366-4488
Fax Number	:	513-366-4480

Provider Business Practice Location Address
First Line	:	8000 5 MILE RD
Second Line	:	SUITE 310
City	:	CINCINNATI
State	:	OH
Zip	:	45230-2163
Country	:	US
Telephone Number	:	513-232-0120
Fax Number	:	513-232-8483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	12/12/2007

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Directions to “ DAVID F DRAKE M.D.” Practice Location

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