Individual
DR. GEORGE JOHAN VAN KOMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105-3208
(801) 464-7660
Mailing address
82 SOUTH 1100 EAST, SUITE 204, SALT LAKE CITY, UT 84102
(801) 350-4602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1558201205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942854058761
—
UT
Enumeration date
05/31/2006
Last updated
11/02/2011
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