Individual
AMANDA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 HAZEL LANE, SUITE 102, SEWICKLEY, PA 15143-1253
(412) 741-5577
(412) 741-1141
Mailing address
111 HAZEL LANE, SUITE 102, SEWICKLEY, PA 15143-1253
(412) 741-5577
(412) 741-1141
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD425883
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012902200001
—
PA
01
—
C01736310
BLUE SHIELD PROVIDER
PA
Enumeration date
08/17/2005
Last updated
11/15/2007
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