Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 170113-1205 | UT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 170113-1205 | UT |
NPI | 1487641437 |
---|---|
Provider Name | Dr. Kenneth Ward |
First Address | Salt Lake City, UT 84109-1660 |
Second Address | Salt Lake City, UT 84109-1660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 03/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F17756 | (02) | HI |