Individual provider Active NPI

George W Drach, M.D.

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1265546006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD065708L Issued in PA
Practice address
3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone
(215) 662-7331
Fax
(215) 662-3955
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD065708L PA Primary

Addresses

Primary practice location

3900 Woodland Ave
Philadelphia, PA 19104-4551

Mailing address

314 S 3Rd St
Philadelphia, PA 19106-4224
Phone (215) 662-7331

Other identifiers 1

IdentifierTypeStateIssuer
01696090MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD065708LPAMDUrology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265546006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S 3RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064224",
            "telephone_number": "215-662-7331",
            "fax_number": "215-662-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "215-662-7331",
            "fax_number": "215-662-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRACH",
        "first_name": "GEORGE",
        "middle_name": "W",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD065708L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01696090",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.