Provider Demographics
NPI:1114950029
Name:SCOMA, CHRISTOPHER D (DC, NMT)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:SCOMA
Suffix:
Gender:M
Credentials:DC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 PIEDMONT RD
Mailing Address - Street 2:BLDG 15, P130
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-477-1589
Mailing Address - Fax:
Practice Address - Street 1:3575 PIEDMONT RD, BLD 15, P130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-477-1589
Practice Address - Fax:404-477-1590
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO005591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85476Medicare UPIN
GA35ZCJQWMedicare ID - Type Unspecified