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NPI Code Detail

MEDICARE: PETER H COOKE M.D.

MEDICARE: PETER H COOKE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianPC049423MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11103312751OTHERMIBCBS
2PC049423OTHERMILIC #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578767406
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER H COOKE M.D.
Provider Business Mailing Address
First Line : 1717 N HIGH ST
Second Line :
City : LANSING
State : MI
Zip : 48906-4529
Country : US
Telephone Number : 517-371-1700
Fax Number : 517-268-6609
Provider Business Practice Location Address
First Line : 1717 N HIGH ST
Second Line :
City : LANSING
State : MI
Zip : 48906-4529
Country : US
Telephone Number : 517-371-1700
Fax Number : 517-268-6609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 03/15/2015

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Directions to “ PETER H COOKE M.D.” Practice Location

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