Individual
DR. JEREMY WILLIAM COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
587 BIELENBERG DR, SUITE 200, WOODBURY, MN 55125-4451
(651) 578-2700
(651) 578-7077
Mailing address
60 PLATO BLVD E, SUITE270, SAINT PAUL, MN 55107-1827
(651) 209-1600
(651) 291-9169
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
52654
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982865317
—
MN
Enumeration date
06/18/2008
Last updated
01/28/2013
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