Provider Demographics
NPI:1336154574
Name:COMESS, MARK P (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:COMESS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1836 LACKLAND HILL PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3572
Mailing Address - Country:US
Mailing Address - Phone:314-989-0300
Mailing Address - Fax:
Practice Address - Street 1:1390 HWY 61
Practice Address - Street 2:SUITE G1000
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2612
Practice Address - Country:US
Practice Address - Phone:636-937-3338
Practice Address - Fax:636-933-7403
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000410213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT42818Medicare UPIN
MO826480244Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MO000013135Medicare ID - Type Unspecified