Provider Demographics
NPI:1851356620
Name:KOMAR, JONATHAN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHARLES
Last Name:KOMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9913 N 95TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4586
Mailing Address - Country:US
Mailing Address - Phone:480-860-8998
Mailing Address - Fax:480-377-9245
Practice Address - Street 1:9522 E SAN SALVADOR DR
Practice Address - Street 2:STE 319
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5557
Practice Address - Country:US
Practice Address - Phone:480-860-8998
Practice Address - Fax:480-377-9245
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ313302081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ74764Medicare ID - Type Unspecified
AZH83895Medicare UPIN