Physician Compare National (NPI:1013019793)

HEALTHCARE PROVIDER: WILLIAM MICHAEL COMLY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013019793
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971495649
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080530000675
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COMLY
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	STONE MEADOW HEALTH AND WELLNESS PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9032410386
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	204 MCCOLLUM ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 203
	Group Practice or individual's line 2 address
City	LARAMIE
	Group Practice or individual's city
State	WY
	Group Practice or individual's state
Zip Code	820705127
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3077458853
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	530025
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	IVINSON MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y