Ian Alexander Neuhaus, PA-C
Physician Assistant in Ponte Vedra, FL. Individual provider (NPI-1).
NPI number1114463288
StatusActive
Last updated in NPPESJul 3, 2024
Details
- NPI
- 1114463288
- Entity type
- Individual (NPI-1)
- Name
- Mr. Ian Alexander Neuhaus
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 13, 2017
- Certification date
- Jul 3, 2024
- Last updated
- Jul 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 2650 | SC | Yes |
Practice location
10870 Us One N Unit 104Ponte Vedra, FL 32081-7804
Phone 904-438-2720
Mailing address
Po Box 751649Charlotte, NC 28275-1649
Phone 843-789-1620
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