Healthcare Provider Details

I. General information

NPI: 1912904657
Provider Name (Legal Business Name): MICHAEL GUS COMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 5TH ST SUITE 104
WINDBER PA
15963-1313
US

IV. Provider business mailing address

700 5TH ST SUITE 104
WINDBER PA
15963-1313
US

V. Phone/Fax

Practice location:
  • Phone: 814-467-9999
  • Fax: 814-467-9977
Mailing address:
  • Phone: 814-467-9999
  • Fax: 814-467-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD045049E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: