Individual
LAURA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
Mailing address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME144858
FL
207PS0010X
Sports Medicine (Emergency Medicine) Physician
83102
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
83102
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
83102
SC
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
83102
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106133100
—
FL
Enumeration date
07/18/2017
Last updated
03/03/2023
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