Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO1817 | ME |
Y | 207Q00000X | Family Doctor | DO1817 | ME |
NPI | 1255356440 |
---|---|
Provider Name | Dr. Kevyn L Comstock |
First Address | Lewiston, ME 04243-7291 |
Second Address | Bangor, ME 04401-5655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 03/02/2022 |