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Individual
MR. WOUTER JOHAN CEYSSENS
Active
Individual
MR. WOUTER JOHAN CEYSSENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5932
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045790
NCCPA CERTIFICATION
—
05
—
358488587A
—
GA
Enumeration date
11/23/2010
Last updated
02/15/2013
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