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NPI Code Detail

MEDICARE: MICHAEL S COOK DC

MEDICARE: MICHAEL S COOK DC
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
1111N00000XChiropractor0104001063VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1324500OTHERVAANTHEM BCBS
2541901720OTHERVATAX ID

General Provider Information

NPI Number : 1578585790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL S COOK DC
Provider Business Mailing Address
First Line : 11015 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-3225
Country : US
Telephone Number : 757-591-7291
Fax Number : 757-591-2125
Provider Business Practice Location Address
First Line : 11015 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-3225
Country : US
Telephone Number : 757-591-7291
Fax Number : 757-591-2125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 06/11/2019

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Directions to “ MICHAEL S COOK DC” Practice Location

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