Individual
KEVIN COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(410) 550-9720
Mailing address
PO BOX 632015, BALTIMORE, MD 21263-2015
(888) 834-7110
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0025770
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022006300
—
MD
05
—
209141100
—
MD
Enumeration date
06/25/2006
Last updated
06/24/2010
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