Provider Demographics
NPI:1386662260
Name:KOMER, LOUIS M (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:M
Last Name:KOMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HIGBEE DRIVE
Mailing Address - Street 2:SUITE B102
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102
Mailing Address - Country:US
Mailing Address - Phone:412-835-8090
Mailing Address - Fax:412-835-8044
Practice Address - Street 1:990 HIGBEE DRIVE
Practice Address - Street 2:SUITE B102
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102
Practice Address - Country:US
Practice Address - Phone:412-835-8090
Practice Address - Fax:412-835-8044
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA050503L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00147109000015Medicaid
PA080060032OtherRAILROAD MEDICARE
PA0014710900002Medicaid
PA101206OtherUPMC
PA37469OtherHEALTH AMERICA
PA0014710900006Medicaid
PA819270OtherAETNA
PA0014710910003Medicaid
PA766426OtherHIGHMARK BC/BS
PA00147109000015Medicaid
PAF78416Medicare UPIN