Individual
GLENDA J COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
418 CLOVERLEAF RD, ELIZABETHTOWN, PA 17022-9320
(717) 653-1467
(717) 653-1001
Mailing address
418 CLOVERLEAF RD, ELIZABETHTOWN, PA 17022-9320
(717) 653-1467
(717) 653-1001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD053135L
PA
207R00000X
Internal Medicine Physician
MD053135L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014654500008
—
PA
01
—
110237772
RAILROAD MEDICARE
PA
01
—
143903
HIGHMARK BLUE SHIELD
PA
01
—
36826 S101
GEISINGER HEALTH PLAN
PA
01
—
4505677
AETNA NON-HMO
PA
01
—
50000533
CAPITAL BLUE CROSS
PA
01
—
513684
AETNA HMIO
PA
01
—
F87562
HEALTH ASSURANCE
PA
01
—
P004427
GATEWAY HEALTH PLAN
PA
Enumeration date
01/23/2006
Last updated
01/11/2017
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