Kenneth Robert Cooke, MD
Pediatrics, Pediatric Hematology-Oncology in Baltimore, MD. Individual provider (NPI-1).
NPI number1104836733
StatusActive
Last updated in NPPESApr 4, 2023
Details
- NPI
- 1104836733
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Robert Cooke
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 8, 2006
- Certification date
- Apr 4, 2023
- Last updated
- Apr 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0207X | Pediatrics, Pediatric Hematology-Oncology | D76204 | MD | Yes |
| 208000000X | Pediatrics | 4301074004 | MI | |
| 2080P0207X | Pediatrics, Pediatric Hematology-Oncology | 4301074004 | MI | |
| 2080P0207X | Pediatrics, Pediatric Hematology-Oncology | 35090984 | OH |
Practice location
Crb1 Rm 2071650 Orleans Street,
Baltimore, MD 21287-0001
Phone 443-287-2949 · Fax 410-502-7223
Mailing address
6201 Greenleigh AveBaltimore, MD 21220-2004
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