| Organization Name: | GEORGE E. DRAKE, M.D., P.C. |
| NPI Number: | 1013114552 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE ERVING DRAKE (PRESIDENT OWNER) |
| Mailing Address: | 1 S 5th St Niles |
| State: | MI US |
| Postal Code: | 491202710 |
| Phone Number: | 2696879607 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 4301034140 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |