Healthcare Provider Details
I. General information
NPI: 1548293723
Provider Name (Legal Business Name): SHARYN M. COMEAU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4515 FALLS OF NEUSE RD
RALEIGH NC
27609-6290
US
IV. Provider business mailing address
13251 FALLS OF NEUSE RD STE 121
RALEIGH NC
27614-8573
US
V. Phone/Fax
- Phone: 919-238-6760
- Fax: 919-238-6760
- Phone: 919-785-5055
- Fax: 984-235-1617
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 200000385 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 2000-00385 |
| License Number State | NC |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 891266E |
| Identifier Type | MEDICAID |
| Identifier State | NC |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: