Provider Demographics
NPI:1578516621
Name:COOK, NAOMI J (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:J
Last Name:COOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:J
Other - Last Name:PEARSALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 W LIBERTY RD
Practice Address - Street 2:STE C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9746
Practice Address - Country:US
Practice Address - Phone:734-761-2581
Practice Address - Fax:734-761-9540
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine