Healthcare Provider Details

I. General information

NPI: 1275665531
Provider Name (Legal Business Name): CHRISTINE R COOK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD ST. MARY'S HOSPITAL
RICHMOND VA
23226-1907
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-281-8222
  • Fax: 804-281-8007
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19623
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101243792
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: