Individual
GRANT COMSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
76917
WI
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
76917
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235591439
—
WI
Enumeration date
03/25/2016
Last updated
11/04/2022
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