Healthcare Provider Details

I. General information

NPI: 1841255296
Provider Name (Legal Business Name): SCOTT ANTHONY COOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E DONNER AVE SUITE 101
MONESSEN PA
15062-1388
US

IV. Provider business mailing address

301 E DONNER AVE SUITE 101
MONESSEN PA
15062-1388
US

V. Phone/Fax

Practice location:
  • Phone: 724-684-8999
  • Fax: 724-684-7073
Mailing address:
  • Phone: 724-684-8999
  • Fax: 724-684-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD073685L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: