Provider Demographics
NPI:1538216338
Name:TIMS-COOK, ZANDRAETTA L (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ZANDRAETTA
Middle Name:L
Last Name:TIMS-COOK
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:3939 LAVISTA RD # 310
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5162
Mailing Address - Country:US
Mailing Address - Phone:844-884-9691
Mailing Address - Fax:404-907-4052
Practice Address - Street 1:2193 CASCADE RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-2862
Practice Address - Country:US
Practice Address - Phone:844-884-9691
Practice Address - Fax:404-907-4052
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-02-12
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Provider Licenses
StateLicense IDTaxonomies
GA63616207R00000X, 207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I445090Medicare PIN