| Mitchell S Drake, MD | |
|
255 West Lancaster Avenue, Paoli, PA 19301 | |
| (610) 648-1043 | |
| Not Available |
| Full Name | Mitchell S Drake |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 255 West Lancaster Avenue, Paoli, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578535522 | NPI | - | NPPES |
| 0018009760006 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | MD070182L (Pennsylvania) | Primary |
| Entity Name | Main Line Emergency Med Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316919368 PECOS PAC ID: 9234034729 Enrollment ID: O20031208000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Mitchell S Drake, MD Po Box 3012, Wilmington, DE 19804 Ph: (800) 456-4629 | Mitchell S Drake, MD 255 West Lancaster Avenue, Paoli, PA 19301 Ph: (610) 648-1043 |
Steven J Gamburg, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 255 West Lancaster Avenue, Paoli, PA 19301 Phone: 610-648-1043 | |
Dr. Raffi V Terzian, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 11 Industrial Blvd, Paoli, PA 19301 Phone: 610-648-1293 Fax: 610-993-0364 | |
Duane K Godshall, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 255 W Lancaster Ave, Paoli, PA 19301 Phone: 610-648-1043 | |
Andrea E Horvath, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 255 W Lancaster Ave, Paoli, PA 19301 Phone: 610-648-1043 | |
Stuart A Brilliant, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 255 W Lancaster Ave, Paoli, PA 19301 Phone: 484-565-1043 Fax: 484-565-1415 | |
Dr. Nicholas Martin Zinn, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 255 W Lancaster Ave Ste 424, Paoli, PA 19301 Phone: 484-565-2580 | |
Marc St Cyr, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 255 W Lancaster Ave, Paoli, PA 19301 Phone: 484-565-1000 |