Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01030 | NC |
Y | 207X00000X | Orthopaedic Surgeon | 200501030 | NC |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 01030 | NC |
NPI | 1215038054 |
---|---|
Provider Name | Dr. Marcus Peter Cook |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28211-1386 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 25/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2043508 | (02) | NC |
5908028 | (05) | NC |
I00979 | (02) | NC |