Provider Demographics
NPI:1356867550
Name:COOK, MEGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 CORBETT RD
Mailing Address - Street 2:
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-1524
Mailing Address - Country:US
Mailing Address - Phone:443-834-8550
Mailing Address - Fax:
Practice Address - Street 1:3200 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3396
Practice Address - Country:US
Practice Address - Phone:410-243-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist