MEDICARE: DR. DAVID A COOK M.D.

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	207RX0202X	Medical Oncology Physician	4301030187	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	111045159	OTHER	MI	TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M006890	OTHER	MI	TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1100979532	OTHER	MI	BLUE CROSS BLUE SHIELD
5	1179532	OTHER	MI	HEALTH PLUS OF MICHIGAN
6	1100979532	OTHER	MI	BLUE CARE NETWORK
7	1004175	OTHER	MI	MCLAREN HEALTH PLAN

General Provider Information

NPI Number	:	1699766642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A COOK M.D.

Provider Business Mailing Address
First Line	:	3140 W CAMPUS DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2776
Country	:	US
Telephone Number	:	989-667-2370
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 W CAMPUS DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706
Country	:	US
Telephone Number	:	989-667-2370
Fax Number	:

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	11/12/2018

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Directions to “ DR. DAVID A COOK M.D.” Practice Location

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