Provider Demographics
NPI:1174613327
Name:DRAKES, GEORGE HUDSON (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:HUDSON
Last Name:DRAKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6188 OXON HILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3113
Mailing Address - Country:US
Mailing Address - Phone:301-856-5860
Mailing Address - Fax:301-856-5864
Practice Address - Street 1:6188 OXON HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3113
Practice Address - Country:US
Practice Address - Phone:301-856-5860
Practice Address - Fax:301-856-5864
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD42188174400000X
DCMD20498208VP0014X, 2081P2900X
VA0101055518208VP0014X, 2081P2900X, 208100000X
MDD0042188208100000X, 208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No174400000XOther Service ProvidersSpecialist
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD168621600Medicaid
MDDD2519OtherMEDICARE RAILROAD #
MDDD2519OtherMEDICARE RAILROAD #
MDE54745Medicare UPIN
DC00B111C40Medicare ID - Type UnspecifiedINDIVIDUAL ID