Healthcare Provider Details

I. General information

NPI: 1114135092
Provider Name (Legal Business Name): GREGORY D COOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CEDARFIELD PKWY
RICHMOND VA
23233-1936
US

IV. Provider business mailing address

PO BOX 2516
MIDLOTHIAN VA
23113-8516
US

V. Phone/Fax

Practice location:
  • Phone: 804-474-8847
  • Fax: 804-968-5544
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0101243815
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101243815
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: