Organization
CRISTO REY COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER H COOKE MD (MEDICAL DIRECTOR)
(517) 371-1700
Entity
Organization
Contact information
Practice address
1717 N HIGH ST, LANSING, MI 48906-4529
(517) 371-1700
(517) 371-4245
Mailing address
1717 N HIGH ST, LANSING, MI 48906-4529
(517) 371-1700
(517) 371-4245
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
SL037010
MI
208D00000X
General Practice Physician
Primary
PC049423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010C362090
BCBS COOKE
MI
05
—
3148943
—
MI
Enumeration date
05/20/2006
Last updated
10/02/2024
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