Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 0101260661 | VA |
N | 207RX0202X | Medical Oncology | MD45198 | TN |
NPI | 1114015989 |
---|---|
Provider Name | Nicholas A. Cook |
First Address | Richlands, VA 24641-0289 |
Second Address | Fredericksburg, VA 22405-2585 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 11/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37285 | (02) | PA |