Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 47528 | MT |
NPI | 1003158551 |
---|---|
Provider Name | Maria Elizabeth Cook |
First Address | Anaconda, MT 59711-1931 |
Second Address | Anaconda, MT 59711-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 20/10/2016 |