Individual
NICHOLAS VON DER AHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 ROUND VALLEY DR STE 201, PARK CITY, UT 84060-7549
(435) 649-7680
(435) 776-9353
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
081963
GA
207Q00000X
Family Medicine Physician
Primary
13447082-1205
UT
Other
Enumeration date
05/16/2017
Last updated
12/29/2023
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