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Individual

DR. DEBORAH LYNN COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
11201 SHAKER BLVD, SUITE 240, CLEVELAND, OH 44104-3869
(216) 721-3668
(216) 707-3706
Mailing address
11201 SHAKER BLVD, SUITE 240, CLEVELAND, OH 44104-3869
(216) 721-3668
(216) 707-3706

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
36003231
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003231
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2246555
OH
01
4190543
MEDICARE PTAN, INDIVIDUAL
OH
01
9384851
MEDICARE PTAN, GROUP
OH
Enumeration date
08/19/2006
Last updated
08/30/2011
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