Individual
KEVEN D KOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 VIRGINIA AVENUE, COLUMBIA, MO 65212-0001
(573) 884-6642
(573) 884-3790
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
04-24580
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
101203
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040481
BCBS KANSAS
KS
05
—
100134990D
—
KS
05
—
203406806
—
MO
01
—
222466
HEALTHLINK
MO
01
—
4294
BCBS MO
MO
Enumeration date
10/06/2006
Last updated
06/08/2012
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