Healthcare Provider Details

I. General information

NPI: 1275283806
Provider Name (Legal Business Name): ADAM SETH COOK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 COLLIERS WAY STE 309
WEIRTON WV
26062-5055
US

IV. Provider business mailing address

PO BOX 779
MORGANTOWN WV
26507-0779
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6560
  • Fax: 304-797-6559
Mailing address:
  • Phone: 304-797-6200
  • Fax: 304-797-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number4999
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4999
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: