Healthcare Provider Details
I. General information
NPI: 1376537191
Provider Name (Legal Business Name): JAMES LOUIS COMERCI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/08/2005
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 E COVE AVE
WHEELING WV
26003-5024
US
IV. Provider business mailing address
PO BOX 3019 7 E COVE AVE STE A
WHEELING WV
26003-0319
US
V. Phone/Fax
- Phone: 304-242-5056
- Fax: 304-242-3647
- Phone: 304-242-5056
- Fax: 304-242-3647
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 12663 |
| License Number State | WV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: