Organization
KOMAN ORTHOPEDICS AND SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON DAVID KOMAN MD (CEO/ORTHOPEDIC SURGEON)
(410) 833-9300
Entity
Organization
Contact information
Practice address
116 WESTMINSTER PIKE, SUITE 100, REISTERSTOWN, MD 21136-1027
(410) 833-9300
Mailing address
116 WESTMINSTER PIKE STE 100, REISTERSTOWN, MD 21136-1027
(410) 833-9300
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
D0055676
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H812A363
MEDICARE PTAN
MD
Enumeration date
01/08/2014
Last updated
06/02/2015
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