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Individual

MR. IAN VANDERWOUDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, MSPAS

Contact information

Practice address
9210 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-5891
(505) 899-3933
Mailing address
9210 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-5891
(505) 899-3933

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2011-0015
NM

Other

Enumeration date
06/12/2011
Last updated
09/15/2025
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