Provider Demographics
NPI:1487656385
Name:COOK, DAVID B (MD MPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:COOK
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 ALLISON POINTE TRL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1682
Mailing Address - Country:US
Mailing Address - Phone:317-284-7672
Mailing Address - Fax:
Practice Address - Street 1:8330 ALLISON POINTE TRL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1682
Practice Address - Country:US
Practice Address - Phone:317-284-7672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024448A207RP1001X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24340Medicare UPIN