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General NPI Number Information
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NPI Number | 1992706808
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Entity Type | Individual
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Provider Name | STEPHEN JEREMY KOMINSKY D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 14418 W MEEKER BLVD STE 205
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5291
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Country | US
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Telephone | 623-546-4930
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Fax | 480-779-1277
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Provider Business Mailing Address
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Address Line | 1 N MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-3592
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Country | US
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Telephone | 410-879-1212
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 01800
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 01800
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License Number State | MD
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