Provider Demographics
NPI:1114095072
Name:COOK, ANDREW D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:COOK
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 1:1600 WESTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-3337
Mailing Address - Country:US
Mailing Address - Phone:804-264-6231
Mailing Address - Fax:804-264-6059
Practice Address - Street 1:1600 WESTBROOK AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-3337
Practice Address - Country:US
Practice Address - Phone:804-264-6231
Practice Address - Fax:804-264-6059
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEEC-05-047207Q00000X
VA0101250360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06734OtherGROUP PTAN