Provider Demographics
NPI:1760529366
Name:COOK, STEPHEN ELBRIDGE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ELBRIDGE
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16 FISHER RD.
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04429
Mailing Address - Country:US
Mailing Address - Phone:207-843-6177
Mailing Address - Fax:
Practice Address - Street 1:185 TOWNSEND AVE STE R
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1895
Practice Address - Country:US
Practice Address - Phone:207-633-1075
Practice Address - Fax:207-633-1067
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME009665207P00000X
MEMD9665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine