MEDICARE: RANDALL RICHARD DRAPER MD

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	208600000X	Surgery Physician	M0051373L	PA

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

General Provider Information

NPI Number	:	1477553766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL RICHARD DRAPER MD

Provider Business Mailing Address
First Line	:	9104 BABCOCK BLVD
Second Line	:	SUITE 1103
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-5818
Country	:	US
Telephone Number	:	412-367-5010
Fax Number	:	412-367-5064

Provider Business Practice Location Address
First Line	:	9104 BABCOCK BLVD
Second Line	:	SUITE 4110
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-5818
Country	:	US
Telephone Number	:	412-367-5010
Fax Number	:	412-367-5064

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/09/2012

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