MEDICARE: DR. PAUL P 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	207RI0200X	Infectious Disease Physician	28161	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110200328	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	24055	OTHER	NC	BCBS NC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760482970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL P COOK MD

Provider Business Mailing Address
First Line	:	PO BOX 751069
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2390 HEMBY LN
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-3775
Country	:	US
Telephone Number	:	252-744-4500
Fax Number	:	252-744-3472

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	02/06/2024

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