Individual
MATTHEW JAMES COOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461-1935
(757) 862-0060
Mailing address
472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461-1935
(757) 862-0060
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437528940
DEPARTMENT OF DEFENSE TRICARE
—
Enumeration date
01/11/2023
Last updated
01/11/2023
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