Drake, Jerry W

Drake, Jerry W is an individual health care provider with primary practice located at 840 Oakwood Blvd , Dearborn MI 48124-2319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Drake, Jerry W can be contacted via phone (313) 359-7650.

Contact Information

Primary practice address
840 Oakwood Blvd Dearborn MI 48124-2319
Phone: (313) 359-7650
Fax: (313) 359-7660
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301045887 Michigan

Profile Details

NPI number 1023055969
LBN Legal business name Drake, Jerry W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Aug 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023055969 NPPES
Michigan MEDICAID 1545891

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