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General NPI Number Information
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NPI Number | 1861935199
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Entity Type | Individual
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Provider Name | DR. DUSTIN A COMSTOCK
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Gender | Male
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 3964 N PEACHTREE RD
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City | ATLANTA
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State | GA
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Zip | 30341-1606
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Country | US
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Telephone | 404-237-2194
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Fax |
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Provider Business Mailing Address
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Address Line | 968 MARBURY CT SW
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City | MARIETTA
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State | GA
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Zip | 30064-2989
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Country | US
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Telephone | 678-333-1206
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH029560
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License Number State | GA
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