Provider Demographics
NPI:1629029731
Name:DRAEGER, STEVEN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHARLES
Last Name:DRAEGER
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 1:1727 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1836
Mailing Address - Country:US
Mailing Address - Phone:614-293-2334
Mailing Address - Fax:614-293-2335
Practice Address - Street 1:1727 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1836
Practice Address - Country:US
Practice Address - Phone:614-293-2334
Practice Address - Fax:614-293-2335
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043925D207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0485756Medicaid
A79611Medicare UPIN
OHDR0482198Medicare PIN