Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 8377 | SC |
Y | 207VG0400X | Gynecologist | 8377 | SC |
NPI | 1124276357 |
---|---|
Provider Name | David Albert Cook |
First Address | Pickens, SC 29671-2319 |
Second Address | Pickens, SC 29671-2319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 14/05/2013 |