Individual
MADISON COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT225882
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MT225882
—
PA
Enumeration date
05/31/2022
Last updated
05/31/2022
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