Individual
KENTON R COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-7093
(919) 784-7395
Mailing address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-7093
(919) 784-7395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200001475
NC
208M00000X
Hospitalist Physician
Primary
200001475
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128MF
BLUE CROSS BLUE SHIELD
—
05
—
89128MF
—
NC
Enumeration date
01/04/2006
Last updated
03/07/2023
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