Individual
DR. BRIAN JAY MCCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1400 E PARKDALE AVE, SUITE #4, MANISTEE, MI 49660-9776
(231) 398-1840
(231) 398-1835
Mailing address
315 OAKGROVE ST, MANISTEE, MI 49660-1176
(231) 398-1950
(231) 398-9268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012971
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0855110425
BLUE CROSS BLUE SHIELD MI
MI
05
—
4566803
—
MI
01
—
760743986100
COMMUNITY CHOICE
—
01
—
7885122
AETNA
—
01
—
900018330
PRIORITY HEALTH
—
01
—
E16002098
MEDICARE PTAN
MI
01
—
P00093145
PALMETTO GBA RR MEDICARE
—
Enumeration date
11/30/2005
Last updated
05/09/2025
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