Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 15892 | NC |
NPI | 1023029485 |
---|---|
Provider Name | Joseph William Cook |
First Address | Charlotte, NC 28260-0122 |
Second Address | Charlotte, NC 28203-5863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
24034 | BCBS (01) | NC |
385108 | (05) | SC |
8924034 | (05) | NC |
C83326 | (02) | |
P00200648 | RAILROAD MEDICARE (01) |