MEDICARE: TERI 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	208000000X	Pediatrics Physician	35.087090	OH
2	207R00000X	Internal Medicine Physician	35.087090	OH

General Provider Information

NPI Number	:	1578563706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERI COOK MD

Provider Business Mailing Address
First Line	:	416 COLEGATE DR BLDG 3
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-9549
Country	:	US
Telephone Number	:	740-374-3526
Fax Number	:	740-374-3165

Provider Business Practice Location Address
First Line	:	807 FARSON ST STE 203C
Second Line	:
City	:	BELPRE
State	:	OH
Zip	:	45714-1069
Country	:	US
Telephone Number	:	740-423-9640
Fax Number	:	740-423-9648

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	06/19/2025

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Directions to “ TERI COOK MD” Practice Location

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