Individual
IAN MICHAEL DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 SHIRCLIFF WAY FL 32204, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
6658 CABLE CAR LN, WILMINGTON, NC 28403-3606
(910) 620-4811
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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