Shrake, Philip

Shrake, Philip is an sole proprietor health care provider with primary practice located at 311 Philip Blvd , Lawrenceville GA 30045-8733. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Shrake, Philip can be contacted via phone (770) 995-3000.

Contact Information

Primary practice address
311 Philip Blvd Lawrenceville GA 30045-8733
Phone: (770) 995-3000
Fax: (770) 995-1427
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 046327 Georgia
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 46327 Georgia

Profile Details

NPI number 1376527531
LBN Legal business name Shrake, Philip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2005
Last updated Oct 1st, 2015 - about 10 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 1376527531 NPPES
Georgia MEDICAID 000809729D
Georgia MEDICAID 00809729A

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