Provider Demographics
NPI:1497717987
Name:COOK, DAVID O (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:O
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1139 CARTHAGE ST STE 110-B
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4111
Mailing Address - Country:US
Mailing Address - Phone:919-775-7232
Mailing Address - Fax:919-775-1731
Practice Address - Street 1:401 MULBERRY ST SW STE 210
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5463
Practice Address - Country:US
Practice Address - Phone:828-757-6431
Practice Address - Fax:828-757-6432
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC29247208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8924028Medicaid
NC340019115OtherRR MEDICARE
NC2344759OtherMEDICARE, GROUP
NC205558FOtherMEDICARE
NC1184163883Medicaid
NCC83325Medicare UPIN
NC2344759OtherMEDICARE, GROUP