Healthcare Provider Details

I. General information

NPI: 1265471908
Provider Name (Legal Business Name): COOKINGHAM BEENE ALLERGY & ASTHMA ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4260 S LINDEN RD
FLINT MI
48507-2977
US

IV. Provider business mailing address

4260 S LINDEN RD
FLINT MI
48507-2977
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-3200
  • Fax: 810-337-1270
Mailing address:
  • Phone: 810-733-3200
  • Fax: 810-337-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CORY EDWARD COOKINGHAM SR.
Title or Position: PRESIDENT COOKINGHAM ALLERGY & ASTH
Credential: MD
Phone: 810-733-3200