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1003070095

NPI Code Detail

MEDICARE: CRAIG R COOK MD

MEDICARE: CRAIG R COOK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2008015959	MO
2	207L00000X	Anesthesiology Physician	57337-20	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61326	OTHER	WI	DEAN HEALTH INSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003070095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG R COOK MD

Provider Business Mailing Address
First Line	:	945 N 12TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-1305
Country	:	US
Telephone Number	:	414-219-6734
Fax Number	:	414-219-4941

Provider Business Practice Location Address
First Line	:	4025 N 92ND ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53222-1613
Country	:	US
Telephone Number	:	414-358-5431
Fax Number	:	414-358-5421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	08/14/2024

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Directions to “ CRAIG R COOK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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