Provider Demographics
NPI:1982184438
Name:COMAN, REBECCA SMITH (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SMITH
Last Name:COMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 BLACKWELL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:
Practice Address - Street 1:5445 MERIDIAN MARK RD STE 270
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4766
Practice Address - Country:US
Practice Address - Phone:404-843-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8876363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical