Individual
DANIEL J DECOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
577 MICHIGAN AVE, SUITE 202, HOLLAND, MI 49423-4911
(616) 394-0673
(616) 394-9825
Mailing address
577 MICHIGAN AVE, SUITE 202, HOLLAND, MI 49423-4911
(616) 394-0673
(616) 394-9825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301051253
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020G010060
BLUE CROSS BLUE SHIELD MI
MI
05
—
3394929
—
MI
01
—
382809956
COMMERCIAL
—
Enumeration date
04/26/2006
Last updated
07/29/2015
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