Individual
CHARLES EDWARD COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2000
Mailing address
927 EAST BLVD, CHARLOTTE, NC 28203-5203
(704) 377-5772
(704) 377-3389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9600495
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911867
—
NC
01
—
N00495
MEDICAID
SC
Enumeration date
10/10/2005
Last updated
04/17/2014
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