Organization
CUMBERLAND GASTROENTEROLOGY, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR ISSA COOK M.D. (PRESIDENT)
(606) 677-2913
Entity
Organization
Contact information
Practice address
56 TOWER CIR, SOMERSET, KY 42503-3476
(606) 677-2913
(606) 677-6983
Mailing address
56 TOWER CIR, SOMERSET, KY 42503-3476
(606) 677-2913
(606) 677-6983
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
34871
KY
363L00000X
Nurse Practitioner
4617P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65933517
—
KY
01
—
7100161540
KY MEDICAID NP GROUP
KY
Enumeration date
10/11/2006
Last updated
06/18/2013
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