Individual
KENNETH ROBERT COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301074004
MI
2080P0207X
Pediatric Hematology & Oncology Physician
35090984
OH
2080P0207X
Pediatric Hematology & Oncology Physician
4301074004
MI
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
D76204
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233275
UNISON
OH
01
—
000000558054
ANTHEM
OH
05
—
2146663
—
OH
05
—
4173898
—
MI
01
—
440046
WELLCARE
OH
01
—
5752459
AETNA
OH
01
—
753959
BUCKEYE
OH
05
—
932856559A
—
GA
Enumeration date
08/08/2006
Last updated
04/04/2023
Update your record
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