Individual
ANDREA E. KOMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 274-8107
(316) 274-8825
Mailing address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 274-8107
(316) 274-8825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00982
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104008
BCBS
KS
05
—
200267600A
—
KS
05
—
200267600D
—
KS
01
—
203790
HPK
KS
01
—
8268
PHS
KS
01
—
KA2985001
MEDICARE PTAN
KS
Enumeration date
08/07/2006
Last updated
12/12/2023
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