Individual
MR. ETHAN KLAUSMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17 AIRPORT RD, WARWICK, RI 02889-1001
(401) 606-3110
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0009110
MD
363A00000X
Physician Assistant
Primary
PA01425
RI
Other
Enumeration date
01/03/2020
Last updated
08/06/2025
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