MEDICARE: DR. CYRUS KOMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	214563	MA

General Provider Information

NPI Number	:	1184602302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRUS KOMER MD

Provider Business Mailing Address
First Line	:	1180 BEACON ST
Second Line	:	SUITE 5A
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3885
Country	:	US
Telephone Number	:	617-739-6300
Fax Number	:	617-734-8484

Provider Business Practice Location Address
First Line	:	1180 BEACON ST
Second Line	:	SUITE 5A
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3885
Country	:	US
Telephone Number	:	617-739-6300
Fax Number	:	617-734-8484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	08/11/2011

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