Individual
DR. NICHOLAS E BEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11106297-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11106297-9934
STATE OF UTAH DEPARTMENT OF COMMERCE
UT
01
—
2376
NC BOARD OF OPTOMETRY
NC
Enumeration date
09/10/2014
Last updated
03/26/2024
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