MEDICARE: MARC JAMES COMIANOS DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	34004891C	OH
2	207R00000X	Internal Medicine Physician	1431	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0673973	OTHER		PALMETTO MEDICARE
7	110071156	OTHER		TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000118340	OTHER	OH	ANTHEM
2	0400998	OTHER		UHC
4	353077	OTHER		SUBMITTER NO
5	635999	OTHER		AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	311098079029	OTHER		CIGNA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013965532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC JAMES COMIANOS DO

Provider Business Mailing Address
First Line	:	PO BOX 3239
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29502-3239
Country	:	US
Telephone Number	:	843-390-8320
Fax Number	:	843-390-8329

Provider Business Practice Location Address
First Line	:	3980 HIGHWAY 9 E STE 100
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-8163
Country	:	US
Telephone Number	:	843-390-8320
Fax Number	:	843-390-8329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/24/2021

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Directions to “ MARC JAMES COMIANOS DO” Practice Location

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