Provider Demographics
NPI:1548369655
Name:COOK, DAVID HARRY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HARRY
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CAPITAL NEUROLOGY
Other - Middle Name:& HEADACHE
Other - Last Name:CENTER, PA.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1219 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4730
Mailing Address - Country:US
Mailing Address - Phone:919-460-5405
Mailing Address - Fax:919-460-5415
Practice Address - Street 1:1219 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4730
Practice Address - Country:US
Practice Address - Phone:919-460-5405
Practice Address - Fax:919-460-5415
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-01-15
Deactivation Date:2012-02-07
Deactivation Code:
Reactivation Date:2013-01-15
Provider Licenses
StateLicense IDTaxonomies
NC9400759174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF92679Medicare UPIN
2338985Medicare ID - Type Unspecified