Healthcare Provider Details

I. General information

NPI: 1831619972
Provider Name (Legal Business Name): THAIS COOKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THAIS MARQUES GURGEL

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1598 S COUNTY TRL STE 201
EAST GREENWICH RI
02818-1762
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-0333
  • Fax: 401-884-0096
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD21532
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number286156
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: