Provider Demographics
NPI:1225024128
Name:COOK, BRUCE R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:R
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:354 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1754
Mailing Address - Country:US
Mailing Address - Phone:978-687-2321
Mailing Address - Fax:978-722-7287
Practice Address - Street 1:354 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1754
Practice Address - Country:US
Practice Address - Phone:978-687-2321
Practice Address - Fax:978-722-7287
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH7608207T00000X
MA57712207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3023249Medicaid
MA4471849OtherAETNA
NH0109258Y0MA01OtherANTHEM
MA05-00252OtherEVERCARE
MA0888895-001OtherCIGNA
MA11514OtherHPHC
MA0003743OtherNHP
MA06-00015OtherUHC
MA23487OtherFCHP
MA715261OtherTHP
NH30002081Medicaid
MAJ06331OtherBCBSMA
MA0888895-001OtherCIGNA
MA23487OtherFCHP
MA0003743OtherNHP