Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 327556 | UT |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301083582 | MI |
N | 207YP0228X | Pediatric Otolaryngology | 4301083582 | MI |
Y | 207YS0123X | Facial Plastic Surgeon | 327556 | UT |
N | 207YS0123X | Facial Plastic Surgeon | 4301083582 | MI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 327556 | UT |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301083582 | MI |
NPI | 1649396185 |
---|---|
Provider Name | Dr. Preston Daniel Ward |
First Address | Salt Lake City, UT 84121-7290 |
Second Address | Salt Lake City, UT 84121-7290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 27/04/2020 |