Provider Demographics
NPI:1568672772
Name:ROBERT A COOK MD PC
Entity Type:Organization
Organization Name:ROBERT A COOK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-487-3940
Mailing Address - Street 1:2206 MITCHELL PARK DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8674
Mailing Address - Country:US
Mailing Address - Phone:231-487-3940
Mailing Address - Fax:231-487-3942
Practice Address - Street 1:2206 MITCHELL PARK DR
Practice Address - Street 2:SUITE 9
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8674
Practice Address - Country:US
Practice Address - Phone:231-487-3940
Practice Address - Fax:231-487-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054235207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P21950Medicare ID - Type Unspecified