Provider Demographics
NPI:1669412375
Name:COOK, DAVID CLEO (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLEO
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2900
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-2900
Mailing Address - Country:US
Mailing Address - Phone:828-778-1690
Mailing Address - Fax:866-369-1915
Practice Address - Street 1:2 S MAIN ST
Practice Address - Street 2:SUITE 23
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-8473
Practice Address - Country:US
Practice Address - Phone:828-778-1690
Practice Address - Fax:866-369-1915
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000102352084P0800X
GA0304462084P0800X
KY509922084P0800X
NC358652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC188030OtherMEDCOST PROVIDER ID #
NC138ENOtherBCBS PROVIDER ID #
NC892389EMedicaid
NC892389EMedicaid
NC188030OtherMEDCOST PROVIDER ID #
NC138ENOtherBCBS PROVIDER ID #