Healthcare Provider Details

I. General information

NPI: 1154345478
Provider Name (Legal Business Name): MATTHEW J COMEAU DO, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 N WASHINGTON ST
PLAINVILLE KS
67663-1632
US

IV. Provider business mailing address

1210 N WASHINGTON ST
PLAINVILLE KS
67663-1632
US

V. Phone/Fax

Practice location:
  • Phone: 785-434-4553
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number05-50303
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: