Provider Demographics
NPI:1417136276
Name:COOK, ALYSSA FLANAGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:FLANAGAN
Last Name:COOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 E. EAGER ST.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-522-9800
Mailing Address - Fax:410-367-2714
Practice Address - Street 1:1000 E. EAGER ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202
Practice Address - Country:US
Practice Address - Phone:410-522-9800
Practice Address - Fax:410-367-2714
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.123141207R00000X, 208000000X
MDD0076411207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics