Provider Demographics
NPI:1114950029
Name:SCOMA, CHRISTOPHER D (DC, NMT)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:SCOMA
Suffix:
Gender:M
Credentials:DC, NMT
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:SCOMA DC NMT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, NMT
Mailing Address - Street 1:235 MOUNT RANIER WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5438
Mailing Address - Country:US
Mailing Address - Phone:404-797-4115
Mailing Address - Fax:
Practice Address - Street 1:3115 PIEDMONT RD NE STE A101
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2526
Practice Address - Country:US
Practice Address - Phone:404-812-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO005591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85476Medicare UPIN
GA35ZCJQWMedicare ID - Type Unspecified