Provider Demographics
NPI:1306820261
Name:RAKE, GEOFFREY W JR (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:W
Last Name:RAKE
Suffix:JR
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 1:11802 LISBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3422
Mailing Address - Country:US
Mailing Address - Phone:301-262-5201
Mailing Address - Fax:
Practice Address - Street 1:1335 E WEST HWY
Practice Address - Street 2:SUITE 6-100
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3225
Practice Address - Country:US
Practice Address - Phone:301-295-8127
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57833207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology