Individual
MICHAEL MCCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4400 E FLAMINGO AVE STE 200, STE 200, NAMPA, ID 83687
(208) 302-2700
(208) 302-2725
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-2700
(208) 302-2725
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-1166
ID
363AS0400X
Surgical Physician Assistant
PA152966
OR
Other
Enumeration date
08/24/2010
Last updated
07/21/2022
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