Provider Demographics
NPI:1487934824
Name:COOKE, CHRISTOPHER LEE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:COOKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 BAYOU
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:248-830-9766
Mailing Address - Fax:
Practice Address - Street 1:6525 W MAPLE RD
Practice Address - Street 2:SUITE 101E
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
Practice Address - Country:US
Practice Address - Phone:248-489-4410
Practice Address - Fax:248-489-4420
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099506207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery