Richard E Cook, Md | |
3450 Old Washington Rd Ste 103 Waldorf MD 20602-3249 | |
(301) 472-4290 | |
(240) 607-3609 |
Full Name | Richard E Cook, Md |
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Speciality | Internal Medicine |
Location | 3450 Old Washington Rd Ste 103, Waldorf, Maryland |
Authorized Official Name and Position | Richard E Cook (OWNER) |
Authorized Official Contact | 3014729240 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Richard E Cook, Md Po Box 215 Bryantown MD 20617-0215 Ph: (301) 472-4290 | Richard E Cook, Md 3450 Old Washington Rd Ste 103 Waldorf MD 20602-3249 Ph: (301) 472-4290 |
NPI Number | 1780852129 |
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Provider Enumeration Date | 02/20/2008 |
Last Update Date | 07/13/2024 |
Medicare PECOS PAC ID | 6406997550 |
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Medicare Enrollment ID | O20100112000021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780852129 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0063483 (Maryland) | Primary |
Provider Name | Betty Siu |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073609038 PECOS PAC ID: 8022064930 Enrollment ID: I20050323001309 |
Provider Name | Richard Cook |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1811970056 PECOS PAC ID: 2567489909 Enrollment ID: I20051025001114 |
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