Individual
AMY FERGUSON COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
109 BARTON CREEK CT, COLUMBIA, SC 29229-8027
(803) 256-2286
(803) 419-8430
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
3071
SC
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3795PA
—
SC
Enumeration date
09/12/2018
Last updated
03/01/2022
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