Provider Demographics
NPI:1942051875
Name:DRAKE, WALTER P (ND)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:P
Last Name:DRAKE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 WARBLER WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-8518
Mailing Address - Country:US
Mailing Address - Phone:910-228-0070
Mailing Address - Fax:
Practice Address - Street 1:241 WARBLER WAY
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-8518
Practice Address - Country:US
Practice Address - Phone:910-228-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200004109954175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath