Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 6492 | NC |
NPI | 1013000199 |
---|---|
Provider Name | Dr. George Thomas Ward JR. |
First Address | Morehead City, NC 28557 |
Second Address | Morehead City, NC 28557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1332825 | UNITED CONCORDIA (01) | |
902GF | BXBS (01) |