Provider Demographics
NPI:1992216048
Name:COOKE, SAMUEL SHAWN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:SHAWN
Last Name:COOKE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:520 JEFFERSON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-689-1822
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:530 SOUTH ST STE G10
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2784
Practice Address - Country:US
Practice Address - Phone:724-689-1335
Practice Address - Fax:724-689-1337
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant