Provider Demographics
NPI:1437188877
Name:COMSTOCK, BARTON L (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:L
Last Name:COMSTOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5515 CLEVELAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-9670
Mailing Address - Country:US
Mailing Address - Phone:269-429-6604
Mailing Address - Fax:269-429-1715
Practice Address - Street 1:5515 CLEVELAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-9670
Practice Address - Country:US
Practice Address - Phone:269-429-6604
Practice Address - Fax:269-429-1715
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030941208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1436188877Medicaid
MI3511107062OtherBLUE CROSS
1013391OtherCIGNA
B48506Medicare UPIN
MI1436188877Medicaid
M35350045Medicare ID - Type Unspecified