Healthcare Provider Details

I. General information

NPI: 1235209719
Provider Name (Legal Business Name): JAMES L COMERCI MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 11/24/2009
Certification Date:
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
WHEELING WV
26003-0319
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-5056
  • Fax: 304-242-3647
Mailing address:
  • Phone: 304-242-5056
  • Fax: 304-242-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number12663
License Number StateWV

VIII. Authorized Official

Name: DR. JAMES L COMERCI
Title or Position: OWNER
Credential: MD
Phone: 304-242-5056