Provider Demographics
NPI:1275897837
Name:COMER, STEVEN MICHAEL (PA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:COMER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-0106
Mailing Address - Country:US
Mailing Address - Phone:865-366-1581
Mailing Address - Fax:865-366-1589
Practice Address - Street 1:1108 FOX MEADOWS BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6939
Practice Address - Country:US
Practice Address - Phone:865-366-1581
Practice Address - Fax:865-366-1589
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2211363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant