Provider Demographics
NPI:1801594957
Name:COOK, MAURCUS SR
Entity type:Individual
Prefix:
First Name:MAURCUS
Middle Name:
Last Name:COOK
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12905 MAPLEROW AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6919
Mailing Address - Country:US
Mailing Address - Phone:216-339-5985
Mailing Address - Fax:
Practice Address - Street 1:12905 MAPLEROW AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-6919
Practice Address - Country:US
Practice Address - Phone:216-339-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management