Organization
KOMAN ORTHOPEDICS AND SPORTS MEDICINE, LLC
Active
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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