Provider Demographics
NPI:1942251517
Name:DRAKEFORD, MICHAEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:DRAKEFORD
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 1:595 W WESMARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1969
Mailing Address - Country:US
Mailing Address - Phone:803-469-4028
Mailing Address - Fax:803-469-2663
Practice Address - Street 1:595 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1969
Practice Address - Country:US
Practice Address - Phone:803-469-4028
Practice Address - Fax:803-469-2663
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11396204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC11396OtherSCLICENSE NUMBER
SC4919Medicare ID - Type UnspecifiedMEDICARE
SCSC11396OtherSCLICENSE NUMBER