Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 000410 | MO |
NPI | 1336154574 |
---|---|
Provider Name | Dr. Mark P Comess |
First Address | Saint Louis, MO 63146-3572 |
Second Address | Festus, MO 63028-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 21/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T42818 | (02) | MO |