Basic Information
| Provider Information | |||||||||
| NPI: | 1225058340 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 E GREENVILLE ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296211580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645121475 | ||||||||
| FaxNumber: | 8645121930 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 E GREENVILLE ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296211580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645121475 | ||||||||
| FaxNumber: | 8645121930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 04/27/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11889 | SC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 118893 | 05 | SC | MEDICAID |