Provider Demographics
NPI:1003918087
Name:KCOMT, CHRISTIAN A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:A
Last Name:KCOMT
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 1:510 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1016
Mailing Address - Country:US
Mailing Address - Phone:888-924-3627
Mailing Address - Fax:888-244-7140
Practice Address - Street 1:510 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1016
Practice Address - Country:US
Practice Address - Phone:717-603-3700
Practice Address - Fax:717-603-3701
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4284292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391904OtherNGS PROVIDER NUMBER
PAMD428429OtherMEDICAL LICENSE
PA707197Medicare PIN