Provider Demographics
NPI:1194963298
Name:DREW, HERBERT THOMAS III (AA)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:THOMAS
Last Name:DREW
Suffix:III
Gender:M
Credentials:AA
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Mailing Address - Street 1:PO BOX 551420
Mailing Address - Street 2:#11E
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-1420
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:954-839-2569
Practice Address - Street 1:1968 PEACHTREE ROAD NW
Practice Address - Street 2:SUITE 515
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-351-1745
Practice Address - Fax:404-351-7121
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2011-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA054492279C0205X
367H00000X
GA005638367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care